Provider Demographics
NPI:1467913574
Name:NOCERA, ANDREA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:NOCERA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 WOLCOTT ST APT 10
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6484
Mailing Address - Country:US
Mailing Address - Phone:203-745-6561
Mailing Address - Fax:
Practice Address - Street 1:2500 COUNTRY DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5356
Practice Address - Country:US
Practice Address - Phone:510-792-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4800224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant