Individual provider Active NPI

Diana Michelle Ortega, LCSW

  • Clinical Social Worker
  • Fillmore, CA
National Provider Identifier
1730788670
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115709 Issued in CA
Practice address
828 W Ventura St Ste 240
Fillmore, CA 93015-1882
Phone
(805) 524-8660
NPI assigned
Oct 21, 2020
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 89588 CA
Clinical Social Worker 1041C0700X 115709 CA Primary

Addresses

Primary practice location

828 W Ventura St Ste 240
Fillmore, CA 93015-1882

Mailing address

303 Citrus St
Santa Paula, CA 93060-2340
Phone (805) 746-4773

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240829001501 CA Practitioner - Clinical Social Worker 0749729135 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89588CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince Jul 1, 2024 Accepting new patients
County of Ventura CurrentSince Jul 1, 2024 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Jul 1, 2025 Accepting new patients

Locations

828 W Ventura St
Ste 240
Fillmore, CA 93015
Phone (805) 524-8660

1911 Williams Dr
Ste 200
Oxnard, CA 93036
Phone (805) 981-4221

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1730788670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CITRUS ST",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930602340",
            "telephone_number": "805-746-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 W VENTURA ST STE 240",
            "city": "FILLMORE",
            "state": "CA",
            "postal_code": "930151882",
            "telephone_number": "805-524-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "DIANA",
        "middle_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "89588",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fillmore, CA

Sources for this page

Verify at the official NPI Registry.