Healthcare Provider Details

I. General information

NPI: 1306212139
Provider Name (Legal Business Name): CATALINA OCAMPO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2015
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WARREN ST
BRIGHTON MA
02135-3680
US

IV. Provider business mailing address

5257 WASHINGTON ST
BOSTON MA
02132-6343
US

V. Phone/Fax

Practice location:
  • Phone: 617-254-3800
  • Fax:
Mailing address:
  • Phone: 973-590-0659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: