Healthcare Provider Details

I. General information

NPI: 1750796348
Provider Name (Legal Business Name): MALAKAI COTE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 CORPORATE WAY
SACRAMENTO CA
95831-3888
US

IV. Provider business mailing address

PO BOX 162384
SACRAMENTO CA
95816-2384
US

V. Phone/Fax

Practice location:
  • Phone: 916-459-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY26409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: