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General NPI Number Information
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NPI Number | 1710703665
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Entity Type | Individual
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Provider Name | BRITTANY NOEL BEVERLIN COTA/L
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 757 W REDLANDS BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4641
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Country | US
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Telephone | 909-783-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 11663 VISTA LN
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City | YUCAIPA
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State | CA
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Zip | 92399-3520
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Country | US
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Telephone | 951-330-9134
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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 | 6995
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License Number State | CA
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