Healthcare Provider Details

I. General information

NPI: 1033963335
Provider Name (Legal Business Name): MICHELE ANN OKOOMIAN COTA/L, CDP, CFPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7960 SOQUEL DR STE B244
APTOS CA
95003-3999
US

IV. Provider business mailing address

7960 SOQUEL DR STE B244
APTOS CA
95003-3999
US

V. Phone/Fax

Practice location:
  • Phone: 401-301-1150
  • Fax:
Mailing address:
  • Phone: 401-301-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: