Jesse R Cooksey, INTERN

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1931 Center St
Berkeley, CA 94704-1105

Phone

(510) 666-9552

Fax

(510) 666-0987

NPI assigned

Jan 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1164760435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 E 27TH ST",
            "address_2": "APT. # A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011912",
            "telephone_number": "510-395-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 CENTER ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041105",
            "telephone_number": "510-666-9552",
            "fax_number": "510-666-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKSEY",
        "first_name": "JESSE",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AC BHCS CLINICIAN # 00",
            "identifier": "000000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Frederick Conrad, D.D.S.
• Ralph Contreras
• Ember Ian Cook, PSYD
• Justin T Cooke
• Deangela Cooks
• Amber Kristin Cooley, MA, LMFT #52498
• Angela Burke Coon
• Crystal Rasheia Cooper
• Ian Cooper, CADC-III
• Joanna A Cooper, M.D.

• Addiction (Substance Use Disorder) Counselor in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.