Provider Demographics
NPI:1649539503
Name:COTAS-GIRARD, ARWIN ANGELAE I (PSYD)
Entity type:Individual
Prefix:
First Name:ARWIN ANGELAE
Middle Name:I
Last Name:COTAS-GIRARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:986 MORAGA RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4423
Mailing Address - Country:US
Mailing Address - Phone:259-954-6229
Mailing Address - Fax:
Practice Address - Street 1:3454 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8238
Practice Address - Country:US
Practice Address - Phone:925-777-6300
Practice Address - Fax:925-777-6300
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31381103TC0700X
225C00000X, 390200000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst