Provider Demographics
NPI:1013947191
Name:LARRY R COTE & KRISTIN B COTE
Entity Type:Organization
Organization Name:LARRY R COTE & KRISTIN B COTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:209-239-3334
Mailing Address - Street 1:250 CHERRY LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-4395
Mailing Address - Country:US
Mailing Address - Phone:209-239-3334
Mailing Address - Fax:209-465-3416
Practice Address - Street 1:250 CHERRY LN
Practice Address - Street 2:SUITE 110
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4395
Practice Address - Country:US
Practice Address - Phone:209-239-3334
Practice Address - Fax:209-465-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW53581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty