Provider Demographics
NPI:1427538412
Name:MOCHO, SARAH ANN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:MOCHO
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 EAGLE ROCK AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3905
Mailing Address - Country:US
Mailing Address - Phone:505-449-8544
Mailing Address - Fax:
Practice Address - Street 1:10100 EAGLE ROCK AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-3905
Practice Address - Country:US
Practice Address - Phone:505-449-8544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-19
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
373H00000X
NM1-22-61017103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist