Provider Demographics
NPI:1427490689
Name:COCHRAN, GINGER (MS, RD)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CASA ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1890
Mailing Address - Country:US
Mailing Address - Phone:805-595-1808
Mailing Address - Fax:805-595-1815
Practice Address - Street 1:35 CASA ST STE 220
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1890
Practice Address - Country:US
Practice Address - Phone:805-595-1808
Practice Address - Fax:805-595-1815
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA991092133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered