Stacie Lyn Cooper, PSY.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

26891 Spring St
San Juan Capistrano, CA 92675-2692

Phone

(949) 361-7892

NPI assigned

Jun 24, 2009

Last updated

Jun 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacie Lyn Cooper Eshelman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245801600000",
    "number": "1003044306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26891 SPRING ST",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26891 SPRING ST",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752692",
            "telephone_number": "949-361-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STACIE",
        "middle_name": "LYN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "ESHELMAN",
            "middle_name": "LYN COOPER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joann Coker, FNP
• Mia Collica, M.S., MFTI
• Grant Collins, MSOM, LAC
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• Jon Conti, M.D
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• Paige Nicole Corbett
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• Thomas Joseph Corrigan, OTR/L
• Costco Wholesale Corporation (Costco Hearing Aid #429)

• Mental Health Counselor in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.