Provider Demographics
NPI:1609689967
Name:OCHOA, IRMA
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
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 1:430 N EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3710
Mailing Address - Country:US
Mailing Address - Phone:650-727-3480
Mailing Address - Fax:650-727-3519
Practice Address - Street 1:1740 MARCO POLO WAY
Practice Address - Street 2:SUITE 4
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4500
Practice Address - Country:US
Practice Address - Phone:650-727-3502
Practice Address - Fax:650-727-3519
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker