Healthcare Provider Details

I. General information

NPI: 1508013285
Provider Name (Legal Business Name): GUADALUPE CONTRERAS OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1297 W HOBSONWAY
BLYTHE CA
92225-1423
US

IV. Provider business mailing address

1297 W HOBSONWAY
BLYTHE CA
92225-1423
US

V. Phone/Fax

Practice location:
  • Phone: 760-921-5690
  • Fax:
Mailing address:
  • Phone: 760-921-5690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: