Active NPI
Candace Marie Coppers
- Addiction (Substance Use Disorder) Counselor
- Riverside, CA
National Provider Identifier
1700390275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1262740817
- Practice address
- 4295 Brockton Ave
Riverside, CA 92501-3446 - Phone
- (951) 567-4235
- NPI assigned
- Nov 20, 2017
- Last updated
- Nov 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1262740817 | CA | Primary |
Addresses
Primary practice location
4295 Brockton Ave
Riverside, CA 92501-3446
Mailing address
4295 Brocton Avenue
Riverside, CA 92501
Phone (951) 341-3786
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1262740817 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511136000000",
"number": "1700390275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4295 BROCTON AVENUE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92501",
"telephone_number": "951-341-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4295 BROCKTON AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925013446",
"telephone_number": "951-567-4235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPPERS",
"first_name": "CANDACE",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-20",
"last_updated": "2017-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1262740817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.