Organization
JUDY CAROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY CAROL COTA/L (OCCUPATIONAL THERAPY ASSISTANT)
(619) 325-0154
Entity
Organization
Contact information
Practice address
3561 QUINCE ST, SAN DIEGO, CA 92104-4819
(619) 283-5816
Mailing address
3561 QUINCE ST, SAN DIEGO, CA 92104-4819
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1705
CA
Other
Enumeration date
03/07/2015
Last updated
07/28/2015
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