Active NPI
Anne Kopp, PH.D.
- Psychologist
- Santa Rosa, CA
National Provider Identifier
1619023264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 9656
- Practice address
- 401 Bicentennial Way
Suite 270
Santa Rosa, CA 95403-2192 - Phone
- (707) 571-3113
- Fax
- (707) 571-4346
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 9656 | CA | Primary |
Addresses
Primary practice location
401 Bicentennial Way
Suite 270
Santa Rosa, CA 95403-2192
Mailing address
320 Judah St
Suite 6
San Francisco, CA 94122-2400
Phone (415) 681-7670
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 9656 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619023264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 JUDAH ST",
"address_2": "SUITE 6",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941222400",
"telephone_number": "415-681-7670",
"fax_number": "415-753-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BICENTENNIAL WAY",
"address_2": "SUITE 270",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032192",
"telephone_number": "707-571-3113",
"fax_number": "707-571-4346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPP",
"first_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 9656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, 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.