Provider Demographics
NPI:1770924730
Name:OCHOA-ANDIA, GLORIA AMPARO (RD, CDE, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:AMPARO
Last Name:OCHOA-ANDIA
Suffix:
Gender:F
Credentials:RD, CDE, IBCLC
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:OCHOA-ANDIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:761 ROSA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6613
Mailing Address - Country:US
Mailing Address - Phone:678-680-3261
Mailing Address - Fax:
Practice Address - Street 1:761 ROSA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6613
Practice Address - Country:US
Practice Address - Phone:678-680-3261
Practice Address - Fax:833-441-1804
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003098133V00000X
IL20920592163WD0400X
VA10522145174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN