Individual
KATY J PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
413 S SUNSET ST APT A, RIDGECREST, CA 93555-4566
(760) 461-0987
Mailing address
413 S SUNSET ST APT A, RIDGECREST, CA 93555-4566
(760) 461-0987
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
E1904908
CA
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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