Provider Demographics
NPI:1669681813
Name:ORTIZ, JANA DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:DIANE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JANA
Other - Middle Name:ORTIZ
Other - Last Name:HATCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:91-1005 KAIHEENALU ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5037
Mailing Address - Country:US
Mailing Address - Phone:808-542-1385
Mailing Address - Fax:808-689-6875
Practice Address - Street 1:550 KUNEHI ST APT 206
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2069
Practice Address - Country:US
Practice Address - Phone:808-674-6641
Practice Address - Fax:866-651-6882
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0253371OtherHMSA
HI58125800OtherALOHA CARE REGULAR
HI990339751-96744-A012OtherTRICARE
HI990339751-96813-B015OtherTRICARE
HI990339751-96701-A014OtherTRICARE
HI990339751-96792-A010OtherTRICARE
HI0000253377OtherHMSA
HI00A0253375OtherHMSA
HI00B0253373OtherHMSA
HIA58125800OtherADVANTAGE CLIENTS-ALOHA