Individual provider Active NPI

Charles R Cosper Jr., LPT, N.C.P.T. 3

  • Licensed Psychiatric Technician
  • San Francisco, CA
National Provider Identifier
1720230170
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
PT26317 Issued in CA
Practice address
815 Buena Vista Ave W
San Francisco, CA 94117-4108
Phone
(415) 762-3700
Fax
(415) 865-0119
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X PT26317 CA Primary

Addresses

Primary practice location

815 Buena Vista Ave W
San Francisco, CA 94117-4108

Mailing address

815 Buena Vista Ave W
San Francisco, CA 94117-4108
Phone (415) 967-7058

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

LicenseStateTypeSpecialty
PT26317CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthright 360 PastSince Jun 11, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1720230170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 BUENA VISTA AVE W",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941174108",
            "telephone_number": "415-967-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BUENA VISTA AVE W",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941174108",
            "telephone_number": "415-762-3700",
            "fax_number": "415-865-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSPER",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPT, N.C.P.T. 3",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT26317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.