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General NPI Number Information
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NPI Number | 1609012335
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Entity Type | Individual
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Provider Name | MRS. JOAN B COCKERILL
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Gender | Female
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 518 GARDEN ST
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City | SANTA BARBARA
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State | CA
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Zip | 93101-1606
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Country | US
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Telephone | 805-963-1569
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Fax |
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Provider Business Mailing Address
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Address Line | 1814 EL FARO
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City | SANTA BARBARA
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State | CA
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Zip | 93109-1903
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Country | US
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Telephone | 805-845-7570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 227
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License Number State | CA
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