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NPI 1164234126

NPI 1164234126 : JOSE OCHOA JR. : FRENCH CAMP, CA

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General NPI Number Information
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    NPI Number           |    1164234126
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    Entity Type          |    Individual 
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    Provider Name        |    JOSE OCHOA JR.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/24/2025
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    Last Update Date     |    01/24/2025
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Provider Practice Location Address
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    Address Line         |    7000 MICHAEL CANLIS WAY 
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    City                 |    FRENCH CAMP
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    State                |    CA
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    Zip                  |    95231-9781
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    Country              |    US
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    Telephone            |    209-468-4400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1334 S PLEASANT AVE 
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    City                 |    LODI
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    State                |    CA
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    Zip                  |    95240-5728
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    Country              |    US
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    Telephone            |    209-400-8149
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    167G00000X
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    Taxonomy Name        |    Licensed Psychiatric Technician
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    License Number       |    42948
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    License Number State |    CA
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