Healthcare Provider Details
I. General information
NPI: 1821744475
Provider Name (Legal Business Name): EDUARDO OCHOA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15526 DUMONT AVE
NORWALK CA
90650-5409
US
IV. Provider business mailing address
15526 DUMONT AVE
NORWALK CA
90650-5409
US
V. Phone/Fax
- Phone: 562-239-7456
- Fax:
- Phone: 562-239-7456
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-21-49448 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | BA-549 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: