Provider Demographics
NPI:1487650560
Name:COCHRANE, JOANNE FENDERSON (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:FENDERSON
Last Name:COCHRANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4196 DURHAM PENTZ RD
Mailing Address - Street 2:
Mailing Address - City:BUTTE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95965-9167
Mailing Address - Country:US
Mailing Address - Phone:530-533-4500
Mailing Address - Fax:530-533-5643
Practice Address - Street 1:2981 OLIVE HWY
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6109
Practice Address - Country:US
Practice Address - Phone:530-533-4500
Practice Address - Fax:530-533-5643
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38720207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G387200Medicaid
DA8251OtherRAILROAD MEDICARE #
6803568590000EOtherBLUE CROSS, BLUE SHIELD
CAA89669Medicare UPIN
CA00G387200Medicaid