Provider Demographics
NPI:1841690336
Name:ORTEGA BRAMBILA, IRIS EDITH
Entity type:Individual
Prefix:MISS
First Name:IRIS
Middle Name:EDITH
Last Name:ORTEGA BRAMBILA
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:POBOX 634
Mailing Address - Street 2:
Mailing Address - City:CHUALAR
Mailing Address - State:CA
Mailing Address - Zip Code:93925
Mailing Address - Country:US
Mailing Address - Phone:831-540-9473
Mailing Address - Fax:
Practice Address - Street 1:141 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-540-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst