Maria Delia Dejarme Fortunato, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95023985 Issued in CA

Practice address

4211 Avalon Blvd
Los Angeles, CA 90011-5622

Phone

(323) 233-0425

NPI assigned

Dec 13, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thrive Psychological Services IncGroup PAC ID 1658744974, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrive Psychological Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ontario, CA
  • NPI 1528640026
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Maria Delia Fortunato Pmhnp BC a Professional Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
  • NPI 1265201222
  NPD Authorized official
• Revive Mental Health Nursing Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Northridge, CA
  • NPI 1619787504
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1174234983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 EAST ST UNIT 805",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202126",
            "telephone_number": "213-377-0012",
            "fax_number": "213-377-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-233-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 S Grand Ave Ste 2450",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900719500",
            "country_code": "US",
            "telephone_number": "213-377-0012 x70012",
            "fax_number": "213-377-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTUNATO",
        "first_name": "MARIA DELIA",
        "middle_name": "DEJARME",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023985",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "861500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Ryan Fortney
• Annie Leola Fortson
• Paula Fortson
• Rupert Fortugaleza, FNP
• Mari Ann Fortuna, LCSW
• Forum Medical Group
• Forward Recovery Solutions, LLC
• Forward Recovery Solutions, LLC
• Forward Urology Medical Group Apc
• Leland Jay Foshag, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.