Active NPI
Marites Ortaliza Tullius, RN NP
- Nurse Practitioner
- Sycmar, CA
National Provider Identifier
1902976046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 16735
- Practice address
- 14445 Olive View Drive
Sycmar, CA 91342-1495 - Phone
- (818) 364-3205
- NPI assigned
- Nov 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 16735 | CA | Primary |
Addresses
Primary practice location
14445 Olive View Drive
Sycmar, CA 91342-1495
Mailing address
5229 Balboa Blvd
Unit 13
Encino, CA 61316-2723
Phone (818) 788-3169
Other names 1
- Miss Marites Soriano Ortaliza
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: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Los Angeles Auditor Controller | Current | Accepting new patients | |
| County of Los Angeles | Current | Accepting new patients | |
| County of Los Angeles | Current | Accepting new patients |
Locations
14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303
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.
-
dba County of Los Angeles Harbor UCLA Medical Center
- General Acute Care Hospital
- Torrance, CA
- NPI 1851363188
-
- Clinic/Center
- Los Angeles, CA
- NPI 1295407401
-
dba Los Angeles County Olive View-UCLA Medical Center
- General Acute Care Hospital
- Sylmar, CA
- NPI 1134159320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902976046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5229 BALBOA BLVD",
"address_2": "UNIT 13",
"city": "ENCINO",
"state": "CA",
"postal_code": "613162723",
"telephone_number": "818-788-3169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14445 OLIVE VIEW DRIVE",
"city": "SYCMAR",
"state": "CA",
"postal_code": "913421495",
"telephone_number": "818-364-3205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLIUS",
"first_name": "MARITES",
"middle_name": "ORTALIZA",
"name_prefix": "Mrs.",
"credential": "RN NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "16735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARITES",
"last_name": "ORTALIZA",
"middle_name": "SORIANO",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.