MEDICARE: MARRIAGE & FAMILY THERAPY BY CHRISTINA AMES-COTTO INC.

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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1205531258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARRIAGE & FAMILY THERAPY BY CHRISTINA AMES-COTTO INC.

Provider Business Mailing Address
First Line	:	6030 SANTO ROAD #133
Second Line	:	STE 1
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-1196
Country	:	US
Telephone Number	:	619-762-3665
Fax Number	:

Provider Business Practice Location Address
First Line	:	4861 ATLANTA DRIVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115
Country	:	US
Telephone Number	:	619-762-3665
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTINA ELIZABETH AMES-COTTO
Credential	:	LMFT
Telephone Number	:	619-762-3665

Provider Enumeration Date	:	03/31/2023
Last Update Date	:	03/31/2023

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