MEDICARE: STEPHANIE ELISE OCHS APCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	10950	CA

General Provider Information

NPI Number	:	1518733344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ELISE OCHS APCC

Provider Business Mailing Address
First Line	:	2725 CONGRESS ST STE 1D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-2766
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2725 CONGRESS ST STE 1D
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-2766
Country	:	US
Telephone Number	:	619-288-6866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2023
Last Update Date	:	12/01/2023

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