NPIMap

Organization Active NPI

Edwyn W. Ortiz-Nance Psychological Services

  • Preferred Provider Organization
  • Fresno, CA
National Provider Identifier
1396156030
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
PSB94020449 Issued in CA
Legal business name
EDWYN W. ORTIZ-NANCE PSYCHOLOGICAL SERVICES
Practice address
2080 N Winery Ave
#101
Fresno, CA 93703-4817
Phone
(559) 252-6353
Fax
(559) 252-7964
NPI assigned
May 15, 2014
Last updated
May 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Authorized official

Name
Dr. Edwyn W. Ortiz-NanceNPI 1467625368
Title
Clinical Psychologist Administrator
Phone
(559) 252-6353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X PSB94020449 CA
Preferred Provider Organization 305R00000X PSB94020449 CA Primary

Addresses

Primary practice location

2080 N Winery Ave
#101
Fresno, CA 93703-4817

Mailing address

2080 N Winery Ave
#101
Fresno, CA 93703-4817
Phone (559) 252-6353

National Provider Directory

National Provider Directory
Tax ID family
Aptitude Habilitation Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2080 N Winery Ave
Ste 101
Fresno, CA 93703
Phone (559) 252-6353

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1396156030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 N WINERY AVE",
            "address_2": "#101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937034817",
            "telephone_number": "559-252-6353",
            "fax_number": "559-252-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 N WINERY AVE",
            "address_2": "#101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937034817",
            "telephone_number": "559-252-6353",
            "fax_number": "559-252-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWYN W. ORTIZ-NANCE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-NANCE",
        "authorized_official_first_name": "EDWYN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST ADMINISTRATOR",
        "authorized_official_telephone_number": "559-252-6353",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "PSB94020449",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "PSB94020449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.