Individual
TERESA ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11838 CENTRAL AVE APT 49, CHINO, CA 91710-1985
(323) 884-6183
Mailing address
11838 CENTRAL AVE APT 49, CHINO, CA 91710-1985
(323) 884-6183
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/22/2016
Last updated
10/22/2016
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