Healthcare Provider Details

I. General information

NPI: 1477078509
Provider Name (Legal Business Name): JERRY OCHOA LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JERRY OCHOA BICBT-CC,GCDF,BC-TMH

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4312 PASADERA WAY
TURLOCK CA
95382-8636
US

IV. Provider business mailing address

4312 PASADERA WAY
TURLOCK CA
95382-8636
US

V. Phone/Fax

Practice location:
  • Phone: 209-985-6332
  • Fax:
Mailing address:
  • Phone: 209-985-6332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number220067690
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC6283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: