Provider Demographics
NPI:1386489474
Name:COTTISS, VITORIA (AMFT)
Entity type:Individual
Prefix:
First Name:VITORIA
Middle Name:
Last Name:COTTISS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:VITORIA
Other - Middle Name:
Other - Last Name:MAGNO-BAPTISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:13001 SEAL BEACH BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2747
Mailing Address - Country:US
Mailing Address - Phone:323-403-5950
Mailing Address - Fax:
Practice Address - Street 1:13001 SEAL BEACH BLVD STE 360
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2747
Practice Address - Country:US
Practice Address - Phone:323-403-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146982106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist