Healthcare Provider Details

I. General information

NPI: 1912447871
Provider Name (Legal Business Name): MANUELA COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3669 VIRGIN ISLANDS CT
PLEASANTON CA
94588-5228
US

IV. Provider business mailing address

3669 VIRGIN ISLANDS CT
PLEASANTON CA
94588-5228
US

V. Phone/Fax

Practice location:
  • Phone: 925-249-9328
  • Fax: 877-570-9724
Mailing address:
  • Phone: 925-249-9328
  • Fax: 877-570-9724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: