Healthcare Provider Details
I. General information
NPI: 1831363977
Provider Name (Legal Business Name): ANN WORKMAN COOTS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/19/2008
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 TYDD ST
EUREKA CA
95501-1284
US
IV. Provider business mailing address
872 UNION ST
ARCATA CA
95521-6035
US
V. Phone/Fax
- Phone: 707-441-1624
- Fax: 707-441-1253
- Phone: 415-730-0555
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA17075 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: