Most Relevant Information
Provider Data
| NPI Number: | 1003550518 |
| Provider Name: | MICHELLE RENETA ORTIZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | R1443050821 |
Most Important Dates
| Enumeration Date: | 04/21/2022 |
| Last Updated: | 04/21/2022 |
Provider Practice Location
126 OHIO ST
VALLEJO
CA
945905049
Practice Location Phone/Fax
| Phone: | 4157072577 |
| Fax: | 7076445501 |
Provider Mailing Location
126 OHIO ST
VALLEJO
CA
945905049
Provider Mailing Phone/Fax
| Phone: | 7076442577 |
| Fax: | 7076445501 |