Basic Information
| Provider Information | |||||||||
| NPI: | 1073114104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OCHOA | ||||||||
| FirstName: | JANINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9919 DE SOTO AVE APT 14 | ||||||||
| Address2: | |||||||||
| City: | CHATSWORTH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913114296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188508545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4955 ALTA ST | ||||||||
| Address2: | |||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930632452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057913725 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2020 | ||||||||
| LastUpdateDate: | 11/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.