Healthcare Provider Details

I. General information

NPI: 1962608117
Provider Name (Legal Business Name): SIVAN KOCHINSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIVAN BARAZANI MA

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18008 SKY PARK CIR STE 110
IRVINE CA
92614-6434
US

IV. Provider business mailing address

15182 MARNE CIR
IRVINE CA
92604-2925
US

V. Phone/Fax

Practice location:
  • Phone: 949-864-6594
  • Fax:
Mailing address:
  • Phone: 805-200-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: