Healthcare Provider Details

I. General information

NPI: 1891368536
Provider Name (Legal Business Name): SAMANTHA OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 09/23/2026
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23822 VALENCIA BLVD STE 208
VALENCIA CA
91355-5639
US

IV. Provider business mailing address

23822 VALENCIA BLVD STE 208
VALENCIA CA
91355-5639
US

V. Phone/Fax

Practice location:
  • Phone: 818-723-4234
  • Fax:
Mailing address:
  • Phone: 818-723-4234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: