Healthcare Provider Details

I. General information

NPI: 1518636307
Provider Name (Legal Business Name): DENISE ALEJANDRA OCHOA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9390 BIG HORN BLVD
ELK GROVE CA
95758-7978
US

IV. Provider business mailing address

9390 BIG HORN BLVD
ELK GROVE CA
95758-7978
US

V. Phone/Fax

Practice location:
  • Phone: 916-683-3955
  • Fax:
Mailing address:
  • Phone: 916-683-3955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number61551
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number61551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: