Angela Christine Cooper, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95020553 Issued in CA

Practice address

99 Almaden Blvd Ste 600
San Jose, CA 95113-1605

Phone

(424) 383-6924

Fax

(424) 329-6144

NPI assigned

Apr 5, 2022

Sex

Female

Sole proprietor

Yes

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

Nurse Practitioner

Practice roles

Locations

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.

• Ehab Yacoub MD Inc.

  • Child & Adolescent Psychiatry Physician
  • Gardena, CA
  • NPI 1417373713
  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1770224859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 CONGAREE LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ALMADEN BLVD STE 600",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951131605",
            "telephone_number": "424-383-6924",
            "fax_number": "424-329-6144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 W Broadway Ste 400",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921013554",
            "country_code": "US",
            "telephone_number": "619-439-0796",
            "fax_number": "619-939-4351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12100 Wilshire Blvd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900257140",
            "country_code": "US",
            "telephone_number": "424-383-6924",
            "fax_number": "424-329-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Cooley, B.A. PYSCHOLOGY
• Lydia Maria Coolidge, M.S.
• Richard Benson Coolman, MD
• Jasmine Orlan Coombs
• Kristen Joy Cooper Borkenhagen, MFT
• Faye Cooper
• Gabriel T. Cooper, PSYD
• Jennifer Cooper, CCC-SLP
• Kotarah Cooper
• Lily Beth Cooper, AGACNP-BC

• Psychiatric/Mental Health Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.