Provider Demographics
NPI:1649081241
Name:ORTEGA - OUNIGIAN, IVETTE
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:ORTEGA - OUNIGIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 HAWKSVIEW PL
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-2504
Mailing Address - Country:US
Mailing Address - Phone:619-816-8818
Mailing Address - Fax:
Practice Address - Street 1:806 HAWKSVIEW PL
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-2504
Practice Address - Country:US
Practice Address - Phone:619-816-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst