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NPI Code Detail

MEDICARE: CAITLIN SPATES COTA

MEDICARE: CAITLIN SPATES 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 Assistant1933CA

General Provider Information

NPI Number : 1437473352
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN SPATES COTA
Provider Business Mailing Address
First Line : 1120 VIA CALLEJON STE B
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92673-6264
Country : US
Telephone Number : 949-498-5100
Fax Number :
Provider Business Practice Location Address
First Line : 1120 VIA CALLEJON STE B
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92673-6264
Country : US
Telephone Number : 949-498-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2010
Last Update Date : 03/22/2010

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Directions to “ CAITLIN SPATES COTA” Practice Location

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