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General NPI Number Information
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NPI Number | 1689610677
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Entity Type | Individual
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Provider Name | KARY R. COTTER LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 6222 LA SALLE AVE
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City | OAKLAND
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State | CA
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Zip | 94611-2804
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Country | US
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Telephone | 510-769-5144
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Fax | 510-769-6190
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Provider Business Mailing Address
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Address Line | 12 REDONDO CT
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City | ALAMEDA
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State | CA
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Zip | 94501-1136
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Country | US
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Telephone | 510-769-7848
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Fax | 510-769-7848
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 124837-3501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 21877
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License Number State | CA
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