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General NPI Number Information
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NPI Number | 1528413648
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Entity Type | Individual
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Provider Name | DARIUS GILCHRIST COTA/L
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Gender | Male
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 3806 CLAYTON RD
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City | CONCORD
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State | CA
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Zip | 94521-2516
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Country | US
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Telephone | 925-685-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 TULIP DR
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City | ANTIOCH
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State | CA
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Zip | 94509-1338
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Country | US
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Telephone | 770-256-6885
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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 | OTA002061
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License Number State | GA
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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 | 3641
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License Number State | CA
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