Provider Demographics
NPI:1609253723
Name:CAYOT, RACHEL LYNNE (COTA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNNE
Last Name:CAYOT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:LYNNE
Other - Last Name:CAYOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:2000 CRYSTAL SPRINGS RD APT 1816
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4646
Mailing Address - Country:US
Mailing Address - Phone:260-402-7527
Mailing Address - Fax:
Practice Address - Street 1:2000 CRYSTAL SPRINGS RD APT 1816
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4646
Practice Address - Country:US
Practice Address - Phone:260-402-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA 1794172V00000X, 224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No172V00000XOther Service ProvidersCommunity Health Worker