Active NPI
Andrew Lowell Cooper, PH.D.
- Clinical Psychologist
- Chula Vista, CA
National Provider Identifier
1003039843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 19460
- Practice address
- 815 3Rd Ave
Suite 107
Chula Vista, CA 91911-1307 - Phone
- (619) 615-8850
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 19460 | CA | Primary |
Addresses
Primary practice location
815 3Rd Ave
Suite 107
Chula Vista, CA 91911-1307
Mailing address
PO Box 86489
San Diego, CA 92138-6489
Phone (619) 615-8850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY194600 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 19460 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382313600000",
"number": "1003039843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86489",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921386489",
"telephone_number": "619-615-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 3RD AVE",
"address_2": "SUITE 107",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919111307",
"telephone_number": "619-615-8850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "ANDREW",
"middle_name": "LOWELL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2013-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 19460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY194600",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.