Individual
ANTONIA ELI ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1650 SPRUCE ST STE 250, RIVERSIDE, CA 92507-7429
(951) 261-4510
Mailing address
7778 LAKESIDE DR, RIVERSIDE, CA 92509-5323
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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