Cockrum, Alicia Dawn
Cockrum, Alicia Dawn is an sole proprietor health care provider with primary practice located at 255 W Napa St Ste K , Sonoma CA 95476-6546. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Rehabilitation, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Cockrum, Alicia Dawn can be contacted via phone (707) 816-2400.Contact Information
Primary practice address
255 W Napa St Ste K
Sonoma CA 95476-6546
Phone: (707) 816-2400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY23519 | California |
| Behavioral Health & Social Service Providers / Health | 103TH0004X | ||
| Behavioral Health & Social Service Providers / Family | 103TF0000X | ||
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | ||
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | ||
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X |
Profile Details
| NPI number | 1962737759 |
|---|---|
| LBN Legal business name | Cockrum, Alicia Dawn |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2009 |
| Last updated | Dec 12th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962737759 | NPPES |
| California | MEDICAID | 268623 |
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