Provider Demographics
NPI:1578620464
Name:KOCHAVI, ORI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ORI
Middle Name:
Last Name:KOCHAVI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 EL CAMINO REAL
Mailing Address - Street 2:KAISER - DEPT. OF CHILD & ADOLESCENT PSYCHIATRY
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3208
Mailing Address - Country:US
Mailing Address - Phone:650-742-2737
Mailing Address - Fax:650-742-7135
Practice Address - Street 1:801 TRAEGER AVE STE 209
Practice Address - Street 2:KAISER - DEPT. OF CHILD & ADOLESCENT PSYCHIATRY
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3048
Practice Address - Country:US
Practice Address - Phone:650-742-2737
Practice Address - Fax:650-742-7135
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16411103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical