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General NPI Number Information
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NPI Number | 1043020902
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Entity Type | Individual
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Provider Name | MARIA GABRIELA DE LA LUZ COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 44840 VALLEY CENTRAL WAY STE 102
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City | LANCASTER
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State | CA
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Zip | 93536-7261
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Country | US
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Telephone | 661-502-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 42041 MOHAVE ROSE DR
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City | QUARTZ HILL
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State | CA
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Zip | 93536-7463
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Country | US
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Telephone | 661-604-3419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 7040
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License Number State | CA
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