Healthcare Provider Details

I. General information

NPI: 1033026612
Provider Name (Legal Business Name): COURTNEY MICHELLE RULIFSON COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6895 MORRO RD
ATASCADERO CA
93422-4122
US

IV. Provider business mailing address

4316 VALDEZ AVE
ATASCADERO CA
93422-2745
US

V. Phone/Fax

Practice location:
  • Phone: 805-464-2133
  • Fax:
Mailing address:
  • Phone: 805-540-0595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number7583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: