Provider Demographics
NPI:1932982964
Name:HOWER, MIRANDA (COTA)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:HOWER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 RUSH RIVER DR APT 321
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-5625
Mailing Address - Country:US
Mailing Address - Phone:925-214-9255
Mailing Address - Fax:
Practice Address - Street 1:1850 E 8TH ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2502
Practice Address - Country:US
Practice Address - Phone:530-756-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6283224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant