Jeffrey David Coutant, COTA
Individual provider Active NPI Occupational Therapist · Fortuna, CA
NPI 1124416748 · NPPES record last updated Jan 5, 2015
Key facts
- NPI
- 1124416748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 1257 (CA)
- Practice address
- 2321 Newburg Rd
Fortuna, CA 95540-2815 - Phone
- (707) 725-4467
- Fax
- (707) 725-1848
- NPI assigned
- Jan 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1257 | CA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1257 | CA | Yes |
Addresses
Primary practice location
2321 Newburg Rd
Fortuna, CA 95540-2815
Mailing address
2321 Newburg Rd
Fortuna, CA 95540-2815
Phone (707) 725-4467
Other providers in Fortuna, CA
- Karen G Chase
- Hyun Ryung Choi
- Church of Loving Hands, Inc.
- Danielle Leighann Cole
- Johnny Keith Coleman
- Cowell Chiropractic Inc
- Michael Henry Crosbie
- Naomi E Cruz
- Lori Ann Cutler
- Francis W Cutruzzola
All providers in Fortuna, CA · Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.