Provider Demographics
NPI:1356014005
Name:COCKMAN, CHELSEA LEIGH
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LEIGH
Last Name:COCKMAN
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 1:16573 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-8762
Mailing Address - Country:US
Mailing Address - Phone:530-559-8954
Mailing Address - Fax:
Practice Address - Street 1:16573 AUBURN RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949-8762
Practice Address - Country:US
Practice Address - Phone:530-273-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator