Tanisha Ortiz – Behavior Analyst in Willow Grove, PA

Key facts

NPI: 1114503000
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Analyst 103K00000X
Practice address: 3625 Welsh Rd Apt L26
Willow Grove, PA 19090-2935
Phone: (148) 493-4824
NPI assigned: Mar 22, 2021
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X		PA
Behavior Analyst	103K00000X			Yes

Addresses

Primary practice location

3625 Welsh Rd Apt L26
Willow Grove, PA 19090-2935

Mailing address

3625 Welsh Rd Apt L26
Willow Grove, PA 19090-2935
Phone (148) 493-4824

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 15, 2021.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1114503000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 WELSH RD APT L26",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902935",
            "telephone_number": "148-493-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 WELSH RD APT L26",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902935",
            "telephone_number": "148-493-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "TANISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

All providers in Willow Grove, PA · Behavior Analyst in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.