Provider Demographics
NPI:1073114104
Name:OCHOA, JANINE
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9919 DE SOTO AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4296
Mailing Address - Country:US
Mailing Address - Phone:818-850-8545
Mailing Address - Fax:
Practice Address - Street 1:4955 ALTA ST
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2452
Practice Address - Country:US
Practice Address - Phone:805-791-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty