Provider Demographics
NPI:1447965264
Name:OCHOA, ANNALIZA MARIE
Entity type:Individual
Prefix:
First Name:ANNALIZA
Middle Name:MARIE
Last Name:OCHOA
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 1:4150 E MAIN ST APT 2111
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-8635
Mailing Address - Country:US
Mailing Address - Phone:480-547-1155
Mailing Address - Fax:
Practice Address - Street 1:4150 E MAIN ST APT 2111
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-8635
Practice Address - Country:US
Practice Address - Phone:480-547-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23470953374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide