Individual provider Active NPI

Myriam Coppens, MFC

  • Marriage & Family Therapist
  • Santa Cruz, CA
National Provider Identifier
1306062534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC12723 Issued in CA
Practice address
104 Walnut Ave
Ste 208
Santa Cruz, CA 95060-3900
Phone
(831) 423-9444
Fax
(831) 423-1532
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC12723 CA Primary

Addresses

Primary practice location

104 Walnut Ave
Ste 208
Santa Cruz, CA 95060-3900

Mailing address

119 Robinson LN
Santa Cruz, CA 95060-2351
Phone (831) 423-9444

Other identifiers 1

IdentifierTypeStateIssuer
MFC12723OtherCALICENSE NUMBER

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
MFC12723CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306062534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 ROBINSON LN",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950602351",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WALNUT AVE",
            "address_2": "STE 208",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603900",
            "telephone_number": "831-423-9444",
            "fax_number": "831-423-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPENS",
        "first_name": "MYRIAM",
        "credential": "MFC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC12723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MFC12723",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.