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Individual

JOHANN DONGON ORTIZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSB

Contact information

Practice address
6363 WILSHIRE BLVD STE 520, LOS ANGELES, CA 90048-5727
(310) 987-7455
Mailing address
6363 WILSHIRE BLVD STE 520, LOS ANGELES, CA 90048-5727
(714) 312-6043

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94028346
CA
104100000X
Social Worker
CA

Other

Enumeration date
08/08/2018
Last updated
08/15/2024
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