Provider Demographics
NPI:1740525567
Name:ORTIZ, CHRISTINA (BHPP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:BHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 W MIRACLE MILE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3708
Mailing Address - Country:US
Mailing Address - Phone:520-750-9667
Mailing Address - Fax:520-750-0056
Practice Address - Street 1:1675 W VALLADOLID DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-1226
Practice Address - Country:US
Practice Address - Phone:520-240-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1944646171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor