Mildred Ortiz, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY28287 Issued in CA

Practice address

18000 Studebaker Rd Ste 700
Cerritos, CA 90703-2684

Phone

(310) 864-0516

Fax

(323) 364-5676

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Mildred Ortiz Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Buena Vibra Psychological Services, Inc.

  • Psychologist
  • Cerritos, CA
  • NPI 1639891682
  NPD (past) Authorized official

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1215081799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 700",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032684",
            "telephone_number": "310-864-0516",
            "fax_number": "323-364-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 700",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032684",
            "telephone_number": "310-864-0516",
            "fax_number": "323-364-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "MILDRED",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-09-15",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY28287",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR system, HIPAA compliant",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office documents, forms, clinical progress notes",
            "address_1": "18000 Studebaker Rd Ste 700",
            "city": "Cerritos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907032684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MILDRED",
            "last_name": "ORTIZ",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Angelica Ortiz Rodriguez
• Aldrin Peter Ortiz
• Corina Ortiz
• Elizabeth Ortiz
• Elliette Valerie Ortiz
• Nadia Ortiz
• Rayleen Ortiz
• Rizalito A. Ortiz Jr., PT
• Oscar E Valenzuela DDS and Philip R Melnick DMD, Inc.
• Ellesse Osorio

• Psychologist in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.