Healthcare Provider Details

I. General information

NPI: 1659821379
Provider Name (Legal Business Name): SARAH JANE OCHOA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 03/29/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CIRCLE OF HOPE DR
SALT LAKE CITY UT
84112-5550
US

IV. Provider business mailing address

7777 S REDWOOD RD
WEST JORDAN UT
84084-5518
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-7000
  • Fax:
Mailing address:
  • Phone: 801-255-9077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12021262-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: