Healthcare Provider Details

I. General information

NPI: 1124357785
Provider Name (Legal Business Name): SEAN COCHRUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 GUERRERO ST
SAN FRANCISCO CA
94110-1015
US

IV. Provider business mailing address

PO BOX 254
POINT REYES STATION CA
94956-0254
US

V. Phone/Fax

Practice location:
  • Phone: 415-621-5661
  • Fax:
Mailing address:
  • Phone: 714-582-5852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number86317
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: