Healthcare Provider Details

I. General information

NPI: 1659088474
Provider Name (Legal Business Name): MR. JOSE JESUS OCHOA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N KAWEAH AVE
EXETER CA
93221-1200
US

IV. Provider business mailing address

516 N KAWEAH AVE
EXETER CA
93221-1200
US

V. Phone/Fax

Practice location:
  • Phone: 559-594-4969
  • Fax: 844-303-5247
Mailing address:
  • Phone: 559-594-4969
  • Fax: 844-303-5247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: