Individual provider · Type 1 NPI
Maria Delia Dejarme Fortunato, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Los Angeles, CA
NPI number
1174234983
Active
Practice location
4211 Avalon Blvd
Los Angeles, CA 90011-5622
Mailing address
2041 East St Unit 805
Concord, CA 94520-2126
Other practice locations
- 355 S Grand Ave Ste 2450, Los Angeles, CA 90071-9500 · (213) 377-0012
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95023985 (CA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 861500 (NV) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1174234983
Maria Delia Dejarme Fortunato, PMHNP-BC's National Provider Identifier is 1174234983, issued on Dec 13, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Los Angeles, CA. The record was last updated on Oct 8, 2025.