Provider Demographics
NPI:1609475318
Name:WASHINGTON-ALLEN, COTY (EMT)
Entity Type:Individual
Prefix:
First Name:COTY
Middle Name:
Last Name:WASHINGTON-ALLEN
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 W WARNER AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1262
Mailing Address - Country:US
Mailing Address - Phone:760-577-8730
Mailing Address - Fax:
Practice Address - Street 1:900 W BELGRAVIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3909
Practice Address - Country:US
Practice Address - Phone:559-265-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE147743146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic