MEDICARE: NAOMI COLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1487541744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI COLE

Provider Business Mailing Address
First Line	:	751 CAMINO PLZ # A
Second Line	:
City	:	SAN BRUNO
State	:	CA
Zip	:	94066-3401
Country	:	US
Telephone Number	:	650-627-8045
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 SAN FELIPE ST STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-1798
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:	866-611-1558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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Directions to “ NAOMI COLE ” Practice Location

Language	Start Address	Practice Location

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