Healthcare Provider Details

I. General information

NPI: 1881773406
Provider Name (Legal Business Name): ELIZABETH M COTTINGHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 MCMILLAN AVE STE 160
SAN LUIS OBISPO CA
93401-6768
US

IV. Provider business mailing address

2180 JOHNSON AVE
SAN LUIS OBISPO CA
93401-4558
US

V. Phone/Fax

Practice location:
  • Phone: 805-781-4179
  • Fax:
Mailing address:
  • Phone: 805-781-4768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberG083288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: