Healthcare Provider Details

I. General information

NPI: 1922454248
Provider Name (Legal Business Name): YUDY OCHOA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 HUNTSMAN PL
BOCA RATON FL
33433-7626
US

IV. Provider business mailing address

8340 HUNTSMAN PL
BOCA RATON FL
33433-7626
US

V. Phone/Fax

Practice location:
  • Phone: 561-706-8629
  • Fax:
Mailing address:
  • Phone: 561-706-8629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: