Healthcare Provider Details

I. General information

NPI: 1619384062
Provider Name (Legal Business Name): TRISHA ANN OCHOA CHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 ARIZONA AVE APT 1
SANTA MONICA CA
90404-1415
US

IV. Provider business mailing address

2620 ARIZONA AVE APT 1
SANTA MONICA CA
90404-1415
US

V. Phone/Fax

Practice location:
  • Phone: 310-428-9098
  • Fax: 310-828-6702
Mailing address:
  • Phone: 310-428-9098
  • Fax: 310-828-6702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: