Healthcare Provider Details

I. General information

NPI: 1174012165
Provider Name (Legal Business Name): CHELSEA BOCK COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 IRIS DR
SALINAS CA
93906-3514
US

IV. Provider business mailing address

7930 W LINCOLN ST NE
MASURY OH
44438-9780
US

V. Phone/Fax

Practice location:
  • Phone: 831-449-1515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: