Provider Demographics
NPI:1679226070
Name:JOSE RODRIGUEZ COTA
Entity Type:Organization
Organization Name:JOSE RODRIGUEZ COTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:171M00000X
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ COTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-868-8156
Mailing Address - Street 1:2151 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2151 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4113
Practice Address - Country:US
Practice Address - Phone:661-868-8156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty