Casey Cooper, PHD

Primary specialty

Exercise & Sports PsychologistTaxonomy code 103TE1100X

License

PSY21348 Issued in CA

Practice address

27281 Las Ramblas
Ste 200
Mission Viejo, CA 92691

Phone

(949) 420-3067

Fax

(949) 305-4171

NPI assigned

Jan 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Casey Ackerman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1073798179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27201 PUERTA REAL",
            "address_2": "STE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917359",
            "telephone_number": "949-420-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27281 LAS RAMBLAS",
            "address_2": "STE 200",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-420-3067",
            "fax_number": "949-305-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "CASEY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21348",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY21348",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "CA",
            "license": "PSY21348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "ACKERMAN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jody Elyse Cook
• Michelle A Cook, PTA
• Sabrina Janelle Cooley, MD
• Shannon Kathleen Coon
• Stephanie Coons, PSYCHOLOGIST
• Coordinated Lab Services, LLC
• Chelsea Danielle Cord, FNP-BC
• Elizabeth Thelma Cordes, PHD, LMFT, JD
• Cordova Medical & Diagnostic Group Inc
• Corey Corpodian DDS, Inc.

• Psychologist in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; 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.