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NPI Code Detail

MEDICARE: MS. DIANNA COTWRIGHT

MEDICARE: MS. DIANNA COTWRIGHT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorRW0830CA

General Provider Information

NPI Number : 1295926509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANNA COTWRIGHT
Provider Business Mailing Address
First Line : 5177 WASHINGHTON AVE. UNIT A
Second Line :
City : CHINO
State : CA
Zip : 91710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 558 N TOWNE AVE
Second Line :
City : POMONA
State : CA
Zip : 91767-4826
Country : US
Telephone Number : 909-622-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 08/05/2007

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