Provider Demographics
NPI:1174988083
Name:COTTRELL, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:COTTRELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 RUSSELL ST APT 301A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2053
Mailing Address - Country:US
Mailing Address - Phone:415-910-1761
Mailing Address - Fax:
Practice Address - Street 1:915 BRYANT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4514
Practice Address - Country:US
Practice Address - Phone:415-777-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)