# JUDY CAROL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619360120
- **Authorized official:** JUDY CAROL COTA/L (OCCUPATIONAL THERAPY ASSISTANT)
- **Authorized official phone:** (619) 325-0154

## Contact information

- **Practice address:** 3561 QUINCE ST, SAN DIEGO, CA 92104-4819
- **Practice address phone:** (619) 283-5816
- **Mailing address:** 3561 QUINCE ST, SAN DIEGO, CA 92104-4819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1705 | CA | Yes |

## Other

- **Enumeration date:** 03/07/2015
- **Last updated:** 07/28/2015