Provider Demographics
NPI:1295371359
Name:TROTTER, COLETTE ELAINE
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:ELAINE
Last Name:TROTTER
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 1:390 N WIGET LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2489
Mailing Address - Country:US
Mailing Address - Phone:925-789-7250
Mailing Address - Fax:925-798-3359
Practice Address - Street 1:2931 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1025
Practice Address - Country:US
Practice Address - Phone:925-676-4840
Practice Address - Fax:925-676-1315
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor