Healthcare Provider Details

I. General information

NPI: 1720898521
Provider Name (Legal Business Name): RUTH OCHOA CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27450 YNEZ RD STE 110A
TEMECULA CA
92591-4649
US

IV. Provider business mailing address

27005 BACK BAY DR
MENIFEE CA
92585-3319
US

V. Phone/Fax

Practice location:
  • Phone: 951-640-3384
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number11041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: