Provider Demographics
NPI:1699228155
Name:OCHOA, LETICIA (MSW)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SW OAK ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1810
Mailing Address - Country:US
Mailing Address - Phone:503-988-6732
Mailing Address - Fax:503-988-5870
Practice Address - Street 1:421 SW OAK ST STE 520
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1810
Practice Address - Country:US
Practice Address - Phone:503-988-6732
Practice Address - Fax:503-988-5870
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 106H00000X, 171M00000X, 175T00000X, 225XM0800X, 390200000X, 1041C0700X
OR1232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program