Alicia Dawn Cockrum, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

255 W Napa St Ste K
Sonoma, CA 95476-6546

Phone

(707) 816-2400

NPI assigned

Oct 12, 2009

Last updated

Dec 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Alicia Dawn Bunten Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1962737759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W NAPA ST STE K",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766546",
            "telephone_number": "707-816-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W NAPA ST STE K",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766546",
            "telephone_number": "707-816-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Emeline Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950601976",
            "country_code": "US",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COCKRUM",
        "first_name": "ALICIA",
        "middle_name": "DAWN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23519",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268623",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "BUNTEN",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• City of Sonoma (Sonoma Valley FireMed System)
• Nidza Clarke, M.S. LMFT
• Lee Ann Clayton, LMFT
• Ceara Kathleen Clementi, AMFT APCC
• Allie Clifford, AMFT
• Katherine Leigh Coletti, LM, CPM
• Collective Illume, a Marriage and Family Therapy Corporation
• Natalie Ann Compagni Portis, MFT, PSYD
• Janet Constantino
• Susie Cook

• Psychologist in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.