Provider Demographics
NPI:1881463024
Name:ORTIZ-MARQUEZ, AUGUSTINA (BSM, LM, CPM)
Entity type:Individual
Prefix:
First Name:AUGUSTINA
Middle Name:
Last Name:ORTIZ-MARQUEZ
Suffix:
Gender:F
Credentials:BSM, LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 1/2 AQUA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3106
Mailing Address - Country:US
Mailing Address - Phone:818-434-7031
Mailing Address - Fax:
Practice Address - Street 1:11050 1/2 AQUA VISTA ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-3106
Practice Address - Country:US
Practice Address - Phone:818-434-7031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA727176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife