Individual provider Active NPI

Connie Cooks

  • Licensed Psychiatric Technician
  • San Diego, CA
National Provider Identifier
1851571939
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Psychiatric TechnicianTaxonomy code 167G00000X
License
23662 Issued in CA
Practice address
600 B St
Suite 1570
San Diego, CA 92101-4520
Phone
(619) 615-0439
Fax
(619) 615-3197
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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 23662 CA Primary

Addresses

Primary practice location

600 B St
Suite 1570
San Diego, CA 92101-4520

Mailing address

600 B St
Suite 1570
San Diego, CA 92101-4520
Phone (619) 615-0439

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
23662CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1851571939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST",
            "address_2": "SUITE 1570",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014520",
            "telephone_number": "619-615-0439",
            "fax_number": "619-615-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 B ST",
            "address_2": "SUITE 1570",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014520",
            "telephone_number": "619-615-0439",
            "fax_number": "619-615-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKS",
        "first_name": "CONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "23662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.