Individual provider Active NPI

Danielle Cooper

  • Marriage & Family Therapist
  • San Pedro, CA
National Provider Identifier
1174364095
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
142445 Issued in CA
Practice address
302 W 5TH St Ste 308
San Pedro, CA 90731-2750
Phone
(424) 570-6955
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 142445 CA Primary

Addresses

Primary practice location

302 W 5TH St Ste 308
San Pedro, CA 90731-2750

Mailing address

302 W 5TH St Ste 308
San Pedro, CA 90731-2750
Phone (424) 570-6955

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
142445CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Counseling, Consulting & Treatment Services, PC CurrentSince Jun 9, 2024 Accepting new patients

Locations

302 W 5th St
Ste 308
San Pedro, CA 90731
Phone (424) 570-6955

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1174364095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W 5TH ST STE 308",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312750",
            "telephone_number": "424-570-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W 5TH ST STE 308",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312750",
            "telephone_number": "424-570-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.