Provider Demographics
NPI:1710129705
Name:OCAMPO, LOURDES
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 CRENSHAW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1727
Mailing Address - Country:US
Mailing Address - Phone:310-787-9694
Mailing Address - Fax:310-787-9713
Practice Address - Street 1:370 CRENSHAW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1727
Practice Address - Country:US
Practice Address - Phone:310-787-9694
Practice Address - Fax:310-787-9713
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator