Healthcare Provider Details

I. General information

NPI: 1366175572
Provider Name (Legal Business Name): JOSELINE OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE UNIT 7
ALHAMBRA CA
91803-8897
US

IV. Provider business mailing address

1342 W 38TH ST
LOS ANGELES CA
90062-1236
US

V. Phone/Fax

Practice location:
  • Phone: 626-457-4254
  • Fax:
Mailing address:
  • Phone: 323-570-8473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: