Most Relevant Information
Provider Data
| NPI Number: | 1003543653 |
| Provider Name: | CLARISSA ADRIANA ORTEGA SUDRC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 13468 |
Most Important Dates
| Enumeration Date: | 08/03/2022 |
| Last Updated: | 08/03/2022 |
Provider Practice Location
2035 FAIRMONT DR
SAN LEANDRO
CA
945781088
Practice Location Phone/Fax
| Phone: | 5103463836 |
| Fax: |
Provider Mailing Location
2035 FAIRMONT DR
SAN LEANDRO
CA
945781088
Provider Mailing Phone/Fax
| Phone: | 5103467836 |
| Fax: |