Provider Demographics
NPI:1922790922
Name:OCAMPO, CHRISTINE CHAIYA ALAJAN (RPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE CHAIYA
Middle Name:ALAJAN
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 N FAIRFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-1714
Mailing Address - Country:US
Mailing Address - Phone:323-383-9897
Mailing Address - Fax:
Practice Address - Street 1:619 N FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-1714
Practice Address - Country:US
Practice Address - Phone:323-383-9897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303616225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist