MEDICARE: MARIANA DO NASCIMENTO VIEIRA COTA/L

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	224Z00000X	Occupational Therapy Assistant	7171	CA

General Provider Information

NPI Number	:	1982577607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANA DO NASCIMENTO VIEIRA COTA/L

Provider Business Mailing Address
First Line	:	12610 CASWELL AVE APT 9
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-7718
Country	:	US
Telephone Number	:	310-985-9563
Fax Number	:

Provider Business Practice Location Address
First Line	:	3233 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-3640
Country	:	US
Telephone Number	:	323-734-9122
Fax Number	:

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

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	09/29/2025

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