Provider Demographics
NPI:1497634976
Name:FORMERLY INCARCERATED STRIVING AND THRIVING AND THE STRIVE THRIVE AND RISE GENERATION
Entity type:Organization
Organization Name:FORMERLY INCARCERATED STRIVING AND THRIVING AND THE STRIVE THRIVE AND RISE GENERATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRPERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-319-9159
Mailing Address - Street 1:212 SARATOGA CT
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2405
Mailing Address - Country:US
Mailing Address - Phone:805-319-9159
Mailing Address - Fax:805-259-4090
Practice Address - Street 1:618 W CHAPEL ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4312
Practice Address - Country:US
Practice Address - Phone:805-319-9159
Practice Address - Fax:805-259-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare