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NPI Code Detail

MEDICARE: JENNY SANDOVAL COTA

MEDICARE:   JENNY  SANDOVAL  COTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantCA

General Provider Information

NPI Number : 1194441576
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY SANDOVAL COTA
Provider Business Mailing Address
First Line : 6123 CARTWRIGHT AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-5004
Country : US
Telephone Number : 626-297-5997
Fax Number :
Provider Business Practice Location Address
First Line : 6123 CARTWRIGHT AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-5004
Country : US
Telephone Number : 626-297-5997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2022
Last Update Date : 10/17/2022

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Directions to “ JENNY SANDOVAL COTA” Practice Location

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