Individual
MR. MICHAEL ANTHONY ORTEGA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3145 MARKET ST APT 212, RIVERSIDE, CA 92501-2471
(951) 823-6381
Mailing address
3145 MARKET ST APT 212, RIVERSIDE, CA 92501-2471
(951) 823-6381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
RH0011410823
CA
251S00000X
Community/Behavioral Health Agency
Primary
24-CCHW-00010
CA
324500000X
Substance Abuse Rehabilitation Facility
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24-CCHW-00010
CERTIFIED COMMUNITY HEALTH WORKER
CA
Enumeration date
05/06/2024
Last updated
08/28/2024
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