Provider Demographics
NPI:1386530095
Name:ORTIZ, HECTOR ABELARDO
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:ABELARDO
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18107 CALAVERAS DR
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8417
Mailing Address - Country:US
Mailing Address - Phone:209-420-4170
Mailing Address - Fax:
Practice Address - Street 1:18107 CALAVERAS DR
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8417
Practice Address - Country:US
Practice Address - Phone:209-420-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist