Provider Demographics
NPI:1710786249
Name:ORTIZ, LETICIA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 LOS ANGELES AVE
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-9730
Mailing Address - Country:US
Mailing Address - Phone:805-746-3850
Mailing Address - Fax:
Practice Address - Street 1:1901 N RICE AVE STE 170
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-7912
Practice Address - Country:US
Practice Address - Phone:805-485-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist