Healthcare Provider Details

I. General information

NPI: 1205666823
Provider Name (Legal Business Name): VANESSA EMELY OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 IOWA AVE
RIVERSIDE CA
92507-0520
US

IV. Provider business mailing address

2020 IOWA AVE
RIVERSIDE CA
92507-0520
US

V. Phone/Fax

Practice location:
  • Phone: 951-822-2975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: