Jennifer Cooper, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15628 Issued in CA

Practice address

902 Bowen Ave
San Jose, CA 95123-5304

Phone

(408) 332-6712

NPI assigned

Dec 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Reynolds Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Calico Speech Therapy, Inc

  • Speech-Language Pathologist
  • San Jose, CA
  • NPI 1760212500
  NPD Authorized official
• Defining Voice

  • Speech-Language Pathologist
  • San Jose, CA
  • NPI 1629445739
  NPD (past)

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1386116267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BOWEN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235304",
            "telephone_number": "408-332-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BOWEN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951235304",
            "telephone_number": "408-332-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JENNIFER",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "15628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REYNOLDS",
            "credential": "CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jasmine Orlan Coombs
• Kristen Joy Cooper Borkenhagen, MFT
• Angela Christine Cooper, PMHNP
• Faye Cooper
• Gabriel T. Cooper, PSYD
• Kotarah Cooper
• Lily Beth Cooper, AGACNP-BC
• Mazon Cooper
• Nazhae J Cooper
• James R Coover, BA. X2 MHRS

• Speech-Language Pathologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.