Individual provider Active NPI

Thomas Ortiz

  • Social Worker
  • Anaheim, CA
National Provider Identifier
1376105577
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
110908 Issued in CA
Practice address
222 S Harbor Blvd Ste 650
Anaheim, CA 92805-3756
Phone
(714) 871-5646
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 110908 CA Primary

Addresses

Primary practice location

222 S Harbor Blvd Ste 650
Anaheim, CA 92805-3756

Mailing address

222 S Harbor Blvd
Anaheim, CA 92805-3700
Phone (714) 871-5646

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

LicenseStateTypeSpecialty
110908CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Oct 1, 2023 Accepting new patients

Locations

505 N Euclid St
Ste 300
Anaheim, CA 92801
Phone (714) 871-5646

222 S Harbor Blvd
Ste 650
Anaheim, CA 92805
Phone (714) 871-5646

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1376105577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S HARBOR BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053700",
            "telephone_number": "714-871-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S HARBOR BLVD STE 650",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053756",
            "telephone_number": "714-871-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "110908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.

Verify at the official NPI Registry.