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General NPI Number Information
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NPI Number | 1447594791
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Entity Type | Individual
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Provider Name | DEBORAH KRESS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 18655 W BERNARDO DR
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City | SAN DIEGO
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State | CA
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Zip | 92127-3002
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Country | US
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Telephone | 858-592-1859
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 720982
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City | SAN DIEGO
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State | CA
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Zip | 92172-0982
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Country | US
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Telephone | 619-713-4699
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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 | 2185
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License Number State | CA
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