Active NPI
Joel A Ortiz
- Rehabilitation Practitioner
- West Covina, CA
National Provider Identifier
1881804714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 1517 W Garvey Ave N
West Covina, CA 91790-2138 - Phone
- (626) 962-6061
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RW0737 | CA | |
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1517 W Garvey Ave N
West Covina, CA 91790-2138
Mailing address
168 S Allen St
San Bernardino, CA 92408-1504
Phone (909) 435-4810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3067 | Other | CA | SIMON STAFF NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RW0737 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1881804714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 S ALLEN ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924081504",
"telephone_number": "909-435-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 W GARVEY AVE N",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902138",
"telephone_number": "626-962-6061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTIZ",
"first_name": "JOEL",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "RW0737",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SIMON STAFF NUMBER",
"identifier": "3067",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.