Provider Demographics
NPI:1134580368
Name:OCEGUEDA, LUZ G
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:G
Last Name:OCEGUEDA
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 1:242 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2628
Mailing Address - Country:US
Mailing Address - Phone:760-556-8370
Mailing Address - Fax:
Practice Address - Street 1:495 E ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-2744
Practice Address - Country:US
Practice Address - Phone:760-353-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X, 104100000X
CA113559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist