MEDICARE: MYLES ANDREW COSTON

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	172V00000X	Community Health Worker
2	390200000X	Student in an Organized Health Care Education/Training Program
3	106H00000X	Marriage & Family Therapist	162292	CA

General Provider Information

NPI Number	:	1558945048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYLES ANDREW COSTON

Provider Business Mailing Address
First Line	:	1340 ARNOLD DR STE 110
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-4189
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 ARNOLD DR STE 110
Second Line	:
City	:	MARTINEZ
State	:	CA
Zip	:	94553-4189
Country	:	US
Telephone Number	:	925-794-9100
Fax Number	:

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

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	03/16/2026

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Directions to “ MYLES ANDREW COSTON ” Practice Location

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