Healthcare Provider Details

I. General information

NPI: 1245164359
Provider Name (Legal Business Name): HANNAH ANISCO COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 S BERETANIA ST STE 201
HONOLULU HI
96814-1825
US

IV. Provider business mailing address

1351 S BERETANIA ST STE 201
HONOLULU HI
96814-1825
US

V. Phone/Fax

Practice location:
  • Phone: 909-434-4182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA-306
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: