Provider Demographics
NPI:1538660519
Name:OHACO, GINA NICOLE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:NICOLE
Last Name:OHACO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 SNOWBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:CA
Mailing Address - Zip Code:95684-9355
Mailing Address - Country:US
Mailing Address - Phone:916-705-5090
Mailing Address - Fax:
Practice Address - Street 1:7700 SNOWBIRD LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:CA
Practice Address - Zip Code:95684-9355
Practice Address - Country:US
Practice Address - Phone:916-705-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-09-5105103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst