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General NPI Number Information
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NPI Number | 1619812294
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Entity Type | Individual
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Provider Name | KEVIN ALLEN ELDRIDGE COTA
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Gender | Male
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 2208 W SUNNYSIDE AVE
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City | VISALIA
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State | CA
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Zip | 93277-7295
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Country | US
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Telephone | 559-627-3274
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Fax |
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Provider Business Mailing Address
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Address Line | 35 E SANTA ANA AVE
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City | FRESNO
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State | CA
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Zip | 93704-2926
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Country | US
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Telephone | 559-627-3274
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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 | 7424
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License Number State | CA
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