Healthcare Provider Details

I. General information

NPI: 1104758689
Provider Name (Legal Business Name): ASHLIN J HAMMOND COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 RICHMAR AVE APT 206
SAN MARCOS CA
92069-2292
US

IV. Provider business mailing address

612 RICHMAR AVE APT 206
SAN MARCOS CA
92069-2292
US

V. Phone/Fax

Practice location:
  • Phone: 469-260-2853
  • Fax:
Mailing address:
  • Phone: 469-260-2853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: