Healthcare Provider Details

I. General information

NPI: 1396272746
Provider Name (Legal Business Name): CHELSEA OCAMPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 05/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S FAIR OAKS AVE
SUNNYVALE CA
94086-7913
US

IV. Provider business mailing address

400 TIMBER WAY
MILPITAS CA
95035-6754
US

V. Phone/Fax

Practice location:
  • Phone: 408-992-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: