Provider Demographics
NPI:1649803693
Name:ORTEGA, EUGENIA
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EUGENIA
Other - Middle Name:
Other - Last Name:LARROQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1547
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-1547
Mailing Address - Country:US
Mailing Address - Phone:858-342-6848
Mailing Address - Fax:
Practice Address - Street 1:15708 POMERADO RD STE 102N
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2035
Practice Address - Country:US
Practice Address - Phone:858-746-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist