Basic Information
| Provider Information | |||||||||
| NPI: | 1912044736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORTEGA | ||||||||
| FirstName: | FRANCINE | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1339 20TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5109815280 | ||||||||
| FaxNumber: | 5109815255 | ||||||||
| Practice Location | |||||||||
| Address1: | 1339 20TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108298609 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 10/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | ASW16082 | CA | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | LCS24571 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.