Provider Demographics
NPI:1699473140
Name:OCHOA, KEVIN (DPT)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:OCHOA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 N HARBOR BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1362
Mailing Address - Country:US
Mailing Address - Phone:148-708-4787
Mailing Address - Fax:
Practice Address - Street 1:1027 N HARBOR BLVD STE B
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1362
Practice Address - Country:US
Practice Address - Phone:714-870-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist