Healthcare Provider Details

I. General information

NPI: 1487343455
Provider Name (Legal Business Name): ALEXANDRA OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 VIA CTR STE B
VISTA CA
92081-6056
US

IV. Provider business mailing address

3652 MICHELSON DR
IRVINE CA
92612-1727
US

V. Phone/Fax

Practice location:
  • Phone: 949-474-1493
  • Fax:
Mailing address:
  • Phone: 949-474-1493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: