Provider Demographics
NPI:1215622196
Name:OCAMPO, JHANNELL HANNAH DIOQUITO
Entity type:Individual
Prefix:
First Name:JHANNELL HANNAH
Middle Name:DIOQUITO
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 1:30000 COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-5335
Mailing Address - Country:US
Mailing Address - Phone:626-250-9430
Mailing Address - Fax:
Practice Address - Street 1:30000 COTTAGE LN
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-5335
Practice Address - Country:US
Practice Address - Phone:626-250-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24767225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist