Healthcare Provider Details

I. General information

NPI: 1265973143
Provider Name (Legal Business Name): CLAUDIA GOVEA OCHOA REGISTER NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19270 SONOMA HIGHWAY
SONOMA CA
95476
US

IV. Provider business mailing address

5389 BENNETT VALLEY RD
SANTA ROSA CA
95404-8554
US

V. Phone/Fax

Practice location:
  • Phone: 707-939-6070
  • Fax:
Mailing address:
  • Phone: 415-686-9344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95099467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: