XANDER JACK COOPER (NPI# 1114403573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114403573 |
Entity Type | Individual |
Full Name | XANDER JACK COOPER |
Practice Address |
4394 30th St San Diego CA 92104 |
Mailing Address |
2929 Meade Ave San Diego CA 92116-4251 |
Practice Telephone | 6192818313 |
Mailing Telephone | 6192818313 |
Enumeration Date | 2018-07-18 |
Last Update Date | 2018-08-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
4394 30TH ST |
City | SAN DIEGO |
State | CA |
Zip Code | 92104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306979406 | Ymca of San Diego County | Residential Treatment Facility, Emotionally Disturbed Children | 4394 30th St, San Diego, CA 92104-1314 | 2007-03-14 |
1588140941 | Kelsey Johnson | Counselor | 4394 30th St, San Diego, CA 92104 | 2018-07-18 |
1932685575 | Diana Alicia Guzman | Social Worker | 4394 30th St, San Diego, CA 92104 | 2018-07-17 |
1841776481 | Selina Warner-kilby | Social Worker | 4394 30th St, San Diego, CA 92104 | 2018-07-17 |
1730665373 | Jennifer Leigh Deane | Student in an Organized Health Care Education/Training Program | 4394 30th St, San Diego, CA 92104 | 2018-07-17 |
1700309523 | Kathryn Elizabeth Grassel | Counselor | 4394 30th St, San Diego, CA 92104-1314 | 2017-07-24 |
1528581345 | Lizette Anaya Sierra | Counselor | 4394 30th St, San Diego, CA 92104-1314 | 2017-07-24 |
1205359023 | Shelly Rose Keene | Counselor | 4394 30th St, San Diego, CA 92104-1314 | 2017-07-24 |
1962925784 | Amanda Sharee Spencer | Counselor | 4394 30th St, San Diego, CA 92104-1314 | 2017-07-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750933610 | Hinderberger Dental Corporation | Dentist | 2050 El Cajon Boulevard, San Diego, CA 92104 | 2019-07-11 |
1912487265 | Graham Ashton Harris | Dentist | 2310 Craven Street, Bldg 3230, Fpo, AA 92104 | 2018-08-16 |
1700393485 | Christian Jacot | Occupational Therapy Assistant | 3128 Nile Street, San Diego, CA 92104 | 2018-01-04 |
1316452931 | Enrico Resurreccion Santos | Dental Hygienist | 2310 Craven St. Bldg. 3230, San Diego, CA 92104 | 2017-12-05 |
1164940789 | Robert Brian Damone | Acupuncturist | 3370 29th Street, San Diego, CA 92104 | 2017-09-04 |
1780100636 | Nicole Palacios | Counselor | 4170 Texas Street, Apt 1, San Diego, CA 92104 | 2017-08-22 |
1063938587 | Indie C Oliver Landrum | Case Manager/Care Coordinator | 2220 Broadway, San Diego, CA 92104 | 2017-08-16 |
1669829008 | Krystah Lynn Smith | Doula | 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 | 2016-05-16 |
1063871853 | Holly Nicole Hinderberger | Dentist | 2050 El Cajon Blvd, San Diego, CA 92104 | 2016-02-22 |
1316336258 | Jorge E Talavera | Military Health Care Provider | 3875 Florida St Apt 2, San Diego, CA 92104 | 2015-01-15 |
Find all providers in zip 92104 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033716204 | Julianne A. Demery | Student in an Organized Health Care Education/Training Program | Naval Base San Diego 2450 Craven Street #3300, San Diego, CA 92136-0001 | 2020-10-01 |
1649885732 | Leanne Evalyn Morancie | Student in an Organized Health Care Education/Training Program | 4231 Balboa Ave # 1245, San Diego, CA 92117-5504 | 2020-09-15 |
1689288136 | Melissa Eileen Fitzgibbon | Student in an Organized Health Care Education/Training Program | 5114 63rd St, San Diego, CA 92115-1407 | 2020-09-02 |
1316550510 | Jessica Elizabeth Knight | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Ct, 310, San Diego, CA 92120 | 2020-08-26 |
1770195091 | Julia Roccanova | Student in an Organized Health Care Education/Training Program | 6383 Alvarado Court, Suite 310, San Diego, CA 92120 | 2020-08-18 |
1861004392 | Mareena Biju | Student in an Organized Health Care Education/Training Program | 10995 Evening Creek Dr E, San Diego, CA 92128-4009 | 2020-08-17 |
1184235202 | Taylor G Wasko | Student in an Organized Health Care Education/Training Program | 4114 Swift Ave Apt 4, San Diego, CA 92104-2249 | 2020-08-12 |
1790394245 | Elisa Melo Da Silva Smerik | Student in an Organized Health Care Education/Training Program | 3235 Loma Riviera Dr, San Diego, CA 92110-5511 | 2020-07-29 |
1215554076 | Ana Mohammad-zadeh | Student in an Organized Health Care Education/Training Program | 17289 Russet St, San Diego, CA 92127-2135 | 2020-06-28 |
1265056048 | Tilbe Yildirim | Student in an Organized Health Care Education/Training Program | 1963 Fourth Ave., San Diego, CA 92101 | 2020-06-08 |
Find all providers in SAN DIEGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.