Provider Demographics
NPI:1821732694
Name:COCHRAN, BRANDON SCOTT
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:SCOTT
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9566 LA JOLLA FARMS RD
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1129
Mailing Address - Country:US
Mailing Address - Phone:424-279-2399
Mailing Address - Fax:
Practice Address - Street 1:340 RANCHEROS DR STE 166
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2980
Practice Address - Country:US
Practice Address - Phone:760-744-3607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)