Healthcare Provider Details

I. General information

NPI: 1356672059
Provider Name (Legal Business Name): ANGELA M OCHOA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 NATIONAL AVE
SAN DIEGO CA
92113-2113
US

IV. Provider business mailing address

8344 CLAIREMONT MESA BLVD SUITE 110
SAN DIEGO CA
92111-1307
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2300
  • Fax:
Mailing address:
  • Phone: 858-565-6910
  • Fax: 858-565-6911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 10999
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: