Provider Demographics
NPI:1093446155
Name:POCHINI, CORRINA MICHELE
Entity Type:Individual
Prefix:MS
First Name:CORRINA
Middle Name:MICHELE
Last Name:POCHINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2761 PRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5174
Mailing Address - Country:US
Mailing Address - Phone:916-770-5465
Mailing Address - Fax:
Practice Address - Street 1:2761 PRESTWICK DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5174
Practice Address - Country:US
Practice Address - Phone:916-770-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program