Healthcare Provider Details

I. General information

NPI: 1225710163
Provider Name (Legal Business Name): KASSANDRA OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 MARBER AVE
LONG BEACH CA
90815-1137
US

IV. Provider business mailing address

2601 MARBER AVE
LONG BEACH CA
90815-1137
US

V. Phone/Fax

Practice location:
  • Phone: 951-266-9420
  • Fax:
Mailing address:
  • Phone: 951-266-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: