Healthcare Provider Details

I. General information

NPI: 1194321638
Provider Name (Legal Business Name): JULIE KAY RICHARDS COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 IRIS DR
SALINAS CA
93906-3514
US

IV. Provider business mailing address

9 CALLE HORCA
RANCHO SANTA MARGARITA CA
92688-2315
US

V. Phone/Fax

Practice location:
  • Phone: 831-449-1515
  • Fax:
Mailing address:
  • Phone: 949-446-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number3053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: