Provider Demographics
NPI:1346732195
Name:COHEN, CODY RENEE (COTA/L)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:RENEE
Last Name:COHEN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:CODY
Other - Middle Name:RENEE
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2293 BIRCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2512
Mailing Address - Country:US
Mailing Address - Phone:330-280-6227
Mailing Address - Fax:
Practice Address - Street 1:250 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-2456
Practice Address - Country:US
Practice Address - Phone:330-280-6227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA4007224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant