Healthcare Provider Details

I. General information

NPI: 1598906208
Provider Name (Legal Business Name): RYAN JOSEPH OCHOA PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WETHERSFIELD AVE
HARTFORD CT
06114-1113
US

IV. Provider business mailing address

2352 COMMONWEALTH AVE
MADISON WI
53711-1909
US

V. Phone/Fax

Practice location:
  • Phone: 860-294-0094
  • Fax: 860-206-1184
Mailing address:
  • Phone: 517-420-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9570
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: