| Cogdiversified Inc | |
|
2022 Vancouver Ave # A Monterey Park CA 91754-5908 | |
| (571) 376-8348 | |
| Not Available |
| Full Name | Cogdiversified Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2022 Vancouver Ave # A, Monterey Park, California |
| Authorized Official Name and Position | Tianjiao Sun (DIRECTOR) |
| Authorized Official Contact | 5713768348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cogdiversified Inc 2022 Vancouver Ave # A Monterey Park CA 91754-5908 Ph: (571) 376-8348 | Cogdiversified Inc 2022 Vancouver Ave # A Monterey Park CA 91754-5908 Ph: (571) 376-8348 |
| NPI Number | 1962221119 |
|---|---|
| Provider Enumeration Date | 10/05/2024 |
| Last Update Date | 09/06/2025 |
| Certification Date | 09/06/2025 |
| Medicare PECOS PAC ID | 2769984657 |
|---|---|
| Medicare Enrollment ID | O20250909001305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962221119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | () | Primary |
| Provider Name | Tianjiao Sun |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1174275309 PECOS PAC ID: 2466961685 Enrollment ID: I20250530001386 |
| Provider Name | Yik Wai Li |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265141634 PECOS PAC ID: 8921505926 Enrollment ID: I20251007002313 |
| Provider Name | Tameka Coleman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245680727 PECOS PAC ID: 8628554367 Enrollment ID: I20260112003159 |
| Provider Name | Channary Voeng |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992459911 PECOS PAC ID: 1456832104 Enrollment ID: I20260220003333 |
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