Active NPI
Marissa Marie Ortega
- Pediatric Occupational Therapist
- San Francisco, CA
National Provider Identifier
1073396917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 25313
- Practice address
- 312 W Portal Ave
San Francisco, CA 94127-1412 - Phone
- (415) 800-7674
- NPI assigned
- Aug 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 25313 | CA | Primary |
Addresses
Primary practice location
312 W Portal Ave
San Francisco, CA 94127-1412
Mailing address
912 6TH Ave
San Bruno, CA 94066-3225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25313 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1073396917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 6TH AVE",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940663225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 W PORTAL AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941271412",
"telephone_number": "415-800-7674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTEGA",
"first_name": "MARISSA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CA",
"license": "25313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.