Wanda Michelle Cooper

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

50136 Issued in CA

Practice address

17130 Sequoia Ave
Suite 103
Hesperia, CA 92395-1827

Phone

(760) 949-1939

Fax

(760) 949-1970

NPI assigned

Dec 12, 2006

Last updated

May 12, 2016By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1770643348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17130 SEQUOIA ST",
            "address_2": "SUITE 103",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923451403",
            "telephone_number": "760-949-1939",
            "fax_number": "760-949-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17130 SEQUOIA AVE",
            "address_2": "SUITE 103",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923951827",
            "telephone_number": "760-949-1939",
            "fax_number": "760-949-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WANDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.