Healthcare Provider Details
I. General information
NPI: 1346045929
Provider Name (Legal Business Name): DAISY GUADALUPE OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/17/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3050 SATURN ST STE 102
BREA CA
92821-6281
US
IV. Provider business mailing address
3050 SATURN ST STE 102
BREA CA
92821-6281
US
V. Phone/Fax
- Phone: 657-444-9002
- Fax:
- Phone: 657-444-9002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: