Provider Demographics
NPI:1669518064
Name:ORTIZ, PAULA JEAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:JEAN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2155 IRON POINT RD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8707
Mailing Address - Country:US
Mailing Address - Phone:916-817-5633
Mailing Address - Fax:916-817-5603
Practice Address - Street 1:2155 IRON POINT RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8707
Practice Address - Country:US
Practice Address - Phone:916-817-5633
Practice Address - Fax:916-817-5603
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS18910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health