Healthcare Provider Details

I. General information

NPI: 1750703880
Provider Name (Legal Business Name): MS. KATERIN LOURDES OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 07/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 ATLANTIC AVE STE 210
LONG BEACH CA
90807
US

IV. Provider business mailing address

3530 ATLANTIC AVE STE 210
LONG BEACH CA
90807-4569
US

V. Phone/Fax

Practice location:
  • Phone: 562-916-6023
  • Fax:
Mailing address:
  • Phone: 562-916-6023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: