Jacqueline K Koppers, PSYD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20514 Issued in CA

Practice address

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780

Phone

(925) 282-1778

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Kristine Koppers Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment Care Compare group NPD
• Cognitive Care Solutions Group Inc

  • Cognitive & Behavioral Psychologist
  • Santa Ana, CA
  • NPI 1548614183
  Medicare reassignment NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1376688374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPERS",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-07-15",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "KOPPERS",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grace Ellen Konstanzer, DC
• Ewa Kontny, M.D.
• Victor S Koo, DPT
• Theresa Koontz, R.N.
• Matthew Edward Kopatz, CCC-SLP
• Bryssa Koppie
• Korean American Center
• Christine Wang Kornu, MD
• Henri Koroveshi, LCSW
• Mila Tsankova Koseva

• Clinical Psychologist in Irvine, CA
• Providers in Irvine, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.