NPIMap

Organization Active NPI

Edwyn W Ortiz-Nance

  • Clinical Psychologist
  • Fresno, CA
National Provider Identifier
1942592621
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
EDWYN W ORTIZ-NANCE
Practice address
2060 N Winery Ave
#102
Fresno, CA 93703-4816
Phone
(559) 252-6353
Fax
(559) 252-7964
NPI assigned
May 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Authorized official

Name
Dr. Edwyn W Ortiz-Nance, PSYDNPI 1467625368
Title
Owner/Clinical Psychologist
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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X

Addresses

Primary practice location

2060 N Winery Ave
#102
Fresno, CA 93703-4816

Mailing address

2060 N Winery Ave
102
Fresno, CA 93703-4816
Phone (559) 252-6353

Other identifiers 1

IdentifierTypeStateIssuer
1467625368OtherCASYNCHRONY OF VISALIA, INC.

Other names 1

  • E.W. Ortiz-Nance, PsyD Psychological Services at the Centre for Harmo Other name

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

2060 N Winery Ave
Ste 102
Fresno, CA 93703
Phone (559) 252-6353

Practitioners & affiliated clinicians

Practitioners 1

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": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1942592621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 N WINERY AVE",
            "address_2": "102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937034816",
            "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": "2060 N WINERY AVE",
            "address_2": "#102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937034816",
            "telephone_number": "559-252-6353",
            "fax_number": "559-252-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWYN W ORTIZ-NANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-NANCE",
        "authorized_official_first_name": "EDWYN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "559-252-6353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SYNCHRONY OF VISALIA, INC.",
            "identifier": "1467625368",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "E.W. Ortiz-Nance, PsyD Psychological Services at the Centre for Harmo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 29, 2011; 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.