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NPI Code Detail

MEDICARE: JORDYN MARIE COCHRAN

MEDICARE: JORDYN MARIE COCHRAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker137042CA
2106S00000XBehavior Technician
3172V00000XCommunity Health Worker
4225400000XRehabilitation Practitioner
5171M00000XCase Manager/Care Coordinator
6373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1063015824
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDYN MARIE COCHRAN
Provider Business Mailing Address
First Line : 25910 ACERO STE 160
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-2777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 HAVEN AVE STE 100
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-5871
Country : US
Telephone Number : 909-980-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2020
Last Update Date : 02/24/2026

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Directions to “ JORDYN MARIE COCHRAN ” Practice Location

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