Provider Demographics
NPI:1376178673
Name:COTTA-WARREN, MARNI MARIE (ASW)
Entity Type:Individual
Prefix:MS
First Name:MARNI
Middle Name:MARIE
Last Name:COTTA-WARREN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10265 ROCKINGHAM DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2566
Mailing Address - Country:US
Mailing Address - Phone:916-768-2921
Mailing Address - Fax:
Practice Address - Street 1:2496 AMERICAN RIVER DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7075
Practice Address - Country:US
Practice Address - Phone:916-398-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8573-S104100000X
CA1024781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8573-SOtherNEVADA STATE BOARD OF EXAMINERS FOR SOCIAL WORKERS
CAASW64616OtherBOARD OF BEHAVIORAL SCIENCES