Provider Demographics
NPI:1275310690
Name:COTY, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:COTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 S WATNEY WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6757
Mailing Address - Country:US
Mailing Address - Phone:530-631-9066
Mailing Address - Fax:
Practice Address - Street 1:2261 S WATNEY WAY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6757
Practice Address - Country:US
Practice Address - Phone:530-631-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker