Provider Demographics
NPI:1750932612
Name:OCAMPO, CLARA BERLANGA
Entity type:Individual
Prefix:MS
First Name:CLARA
Middle Name:BERLANGA
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 1:348 S GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-5959
Mailing Address - Country:US
Mailing Address - Phone:951-400-6257
Mailing Address - Fax:
Practice Address - Street 1:42485 ROUNDUP DR
Practice Address - Street 2:
Practice Address - City:AGUANGA
Practice Address - State:CA
Practice Address - Zip Code:92536-9340
Practice Address - Country:US
Practice Address - Phone:619-307-4654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF6976183OtherDRIVER LICENSE