Healthcare Provider Details

I. General information

NPI: 1962292771
Provider Name (Legal Business Name): ROBERT JOSHUA UREN COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8755 AERO DR STE 100
SAN DIEGO CA
92123-1750
US

IV. Provider business mailing address

1517 AVOCADO WAY
ESCONDIDO CA
92026-2230
US

V. Phone/Fax

Practice location:
  • Phone: 619-578-2232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number7148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: