Provider Demographics
NPI:1003944984
Name:AMIAL-COTA, YADIRA (LMFT)
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:AMIAL-COTA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:YADIRA
Other - Middle Name:
Other - Last Name:AMIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1702 E BULLARD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5800
Mailing Address - Country:US
Mailing Address - Phone:559-974-5510
Mailing Address - Fax:559-446-1942
Practice Address - Street 1:1702 E BULLARD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5800
Practice Address - Country:US
Practice Address - Phone:559-974-5510
Practice Address - Fax:559-446-1942
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist