Healthcare Provider Details

I. General information

NPI: 1891659090
Provider Name (Legal Business Name): ALEJANDRA OCEGUERA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 ALLEGAN CIR
SAN JOSE CA
95123-5003
US

IV. Provider business mailing address

119 HOLLAND ST
EAST PALO ALTO CA
94303-1415
US

V. Phone/Fax

Practice location:
  • Phone: 702-613-3775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: