Provider Demographics
NPI:1619345808
Name:OCHOA, IRENE (CADC 1)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:CADC 1
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:CAMPOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8450 SE AMITY DAYTON HWY
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8710
Mailing Address - Country:US
Mailing Address - Phone:971-267-8048
Mailing Address - Fax:
Practice Address - Street 1:627 NE EVANS ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-3923
Practice Address - Country:US
Practice Address - Phone:503-434-7523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker