Individual provider Active NPI

Eileen Van Koppen, PSYD, MFT

  • Psychoanalyst
  • Santa Barbara, CA
National Provider Identifier
1063759157
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
Practice address
1010 Garden St
Santa Barbara, CA 93101-1417
Phone
(805) 965-2503
Fax
(805) 565-1215
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFT40016 CA
Psychoanalyst 102L00000X Primary

Addresses

Primary practice location

1010 Garden St
Santa Barbara, CA 93101-1417

Mailing address

1010 Garden St
Santa Barbara, CA 93101-1417
Phone (805) 965-2503

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT40016CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1063759157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 GARDEN ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931011417",
            "telephone_number": "805-965-2503",
            "fax_number": "805-565-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 GARDEN ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931011417",
            "telephone_number": "805-965-2503",
            "fax_number": "805-565-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KOPPEN",
        "first_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "PSYD, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT40016",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.