Provider Demographics
NPI:1053980482
Name:ORENDAIN, HECTOR EDUARDO
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:EDUARDO
Last Name:ORENDAIN
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 1:2221 FANTASY LN
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-1605
Mailing Address - Country:US
Mailing Address - Phone:619-782-1156
Mailing Address - Fax:
Practice Address - Street 1:8555 AERO DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1745
Practice Address - Country:US
Practice Address - Phone:858-244-5176
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician