Kayla Rosalyn Cooper, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

11669 Santa Monica Blvd Ste 110
Los Angeles, CA 90025-2929

Phone

(310) 315-4989

Fax

(310) 998-3282

NPI assigned

Oct 29, 2021

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1427712900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11669 SANTA MONICA BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252929",
            "telephone_number": "310-315-4989",
            "fax_number": "310-998-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11669 SANTA MONICA BLVD STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900252929",
            "telephone_number": "310-315-4989",
            "fax_number": "310-998-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KAYLA",
        "middle_name": "ROSALYN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Cooper
• Joan Smith Cooper, PH.D.
• John Cooper, D.O.
• Joseph Cooper, M.D.
• Joseph Paul Anthony Cooper, FNP-C
• Kelly Cooper
• Kerry Dale Cooper
• Khidell Cooper
• Lanae Cooper
• Leroy Cooper, P.A.

• Medical Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.