MEDICARE: JUDITH COTTON MFT

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	MFT32063	CA

General Provider Information

NPI Number	:	1750589420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH COTTON MFT

Provider Business Mailing Address
First Line	:	16260 VENTURA BLVD
Second Line	:	415
City	:	ENCINO
State	:	CA
Zip	:	91436-2203
Country	:	US
Telephone Number	:	818-342-1923
Fax Number	:	818-342-1923

Provider Business Practice Location Address
First Line	:	16260 VENTURA BLVD
Second Line	:	415
City	:	ENCINO
State	:	CA
Zip	:	91436-2203
Country	:	US
Telephone Number	:	818-342-1923
Fax Number	:	818-342-1923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2007
Last Update Date	:	07/08/2007

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Directions to “ JUDITH COTTON MFT” Practice Location

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