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General NPI Number Information
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NPI Number | 1700700390
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Entity Type | Individual
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Provider Name | CIERRA JOHNSON COTA
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 325 N BERGIN LN
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City | BLOOMFIELD
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State | NM
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Zip | 87413-6729
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Country | US
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Telephone | 505-632-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 205 W CEDAR AVE
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City | BLOOMFIELD
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State | NM
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Zip | 87413-5941
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Country | US
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Telephone | 505-632-4314
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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 | OT-2026-0098
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License Number State | NM
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