Individual
FELICIA NICOLEMARIE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 E 2ND ST, POMONA, CA 91766-1854
(909) 623-6116
Mailing address
309 E 2ND ST, POMONA, CA 91766-1854
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA65128
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2024
Last updated
09/27/2024
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