Provider Demographics
NPI:1902599285
Name:COTO, WENDY ELIZABETH
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ELIZABETH
Last Name:COTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15601 TUSTIN VILLAGE WAY APT 23
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-4989
Mailing Address - Country:US
Mailing Address - Phone:562-386-3400
Mailing Address - Fax:
Practice Address - Street 1:15602 TUSTIN VILLAGE WAY APT 23
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:562-386-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst