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General NPI Number Information
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NPI Number | 1508563719
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Entity Type | Individual
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Provider Name | JESSIE BORJA COTA/L
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Gender | Female
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1101 E TUOLUMNE RD
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City | TURLOCK
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State | CA
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Zip | 95382-1541
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Country | US
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Telephone | 408-992-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 2806 W 23RD ST
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City | GREELEY
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State | CO
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Zip | 80634-7618
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Country | US
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Telephone | 619-977-5294
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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 | OTA-1632
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 449293
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA.0001424
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA6012
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License Number State | CA
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