Healthcare Provider Details

I. General information

NPI: 1144166976
Provider Name (Legal Business Name): MISS ELIZABETH IRENE COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 S MOONEY BLVD
VISALIA CA
93277-9396
US

IV. Provider business mailing address

2537 N CHINOWTH ST
VISALIA CA
93291-8197
US

V. Phone/Fax

Practice location:
  • Phone: 559-972-8422
  • Fax:
Mailing address:
  • Phone: 559-972-8422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number8573
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: