Provider Demographics
NPI:1306399118
Name:OCHOA, SHAMAR NICOLE (HHA)
Entity Type:Individual
Prefix:
First Name:SHAMAR
Middle Name:NICOLE
Last Name:OCHOA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5258
Mailing Address - Country:US
Mailing Address - Phone:202-558-2448
Mailing Address - Fax:
Practice Address - Street 1:5501 1ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5258
Practice Address - Country:US
Practice Address - Phone:202-558-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11036251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health