DR. TAKESHA JENENE COOPER (NPI# 1679794069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679794069 |
| Entity Type | Individual |
| Full Name | DR. TAKESHA JENENE COOPER |
| Other Name | DR. TAKESHA JENENE VALENTINE |
| Credential | MD |
| Practice Address |
31946 Mission Trl Suite B Lake Elsinore CA 92530-4539 |
| Practice Telephone | 9512457663 |
| Practice Fax Number | 9516746431 |
| Mailing Telephone | 9512457663 |
| Mailing Fax Number | 9516746431 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-09-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A88199 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
A88199 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A881990 | 05 |
| Street Address |
31946 MISSION TRL SUITE B |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-4539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790819464 | Donna Evelyn | Psychologist | 31946 Mission Trl, Ste B, Lake Elsinore, CA 92530-4539 | 2007-03-15 |
| 1508217357 | Crystal Guerrero | Counselor | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2016-06-23 |
| 1407203854 | Edgard Eduardo Villa Jr. | Counselor | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2016-05-16 |
| 1386036648 | Leah Myhanh Barden | Peer Specialist | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2015-02-24 |
| 1245646876 | Celeste Quintero | Marriage & Family Therapist | 31946 Mission Trl, Ste. B, Lake Elsinore, CA 92530-4539 | 2014-07-03 |
| 1467868034 | Diana Fernandez | Marriage & Family Therapist | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2014-07-03 |
| 1578835781 | Maria Gabriela Garcia | Case Manager/Care Coordinator | 31946 Mission Trl, Ste.b, Lake Elsinore, CA 92530-4539 | 2012-02-02 |
| 1033487707 | Carina B Gustafsson | Marriage & Family Therapist | 31946 Mission Trl, Ste B, Lake Elsinore, CA 92530-4539 | 2011-12-08 |
| 1720378573 | Patricia Lamas | Marriage & Family Therapist | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2011-04-13 |
| 1831427285 | Thuy Hoang Ulrich | Marriage & Family Therapist | 31946 Mission Trl, Suite B, Lake Elsinore, CA 92530-4539 | 2009-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851445589 | Mohamed Yaser Elatrozy | Psychiatry & Neurology | 265 San Jacinto River Rd, 107, Lake Elsinore, CA 92530 | 2007-01-22 |
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| 1225527427 | Better Life Therapy, Inc. | Psychiatry & Neurology | 9520 Escondido Canyon Rd, Santa Clarita, CA 91390-4811 | 2018-05-03 |
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| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1255871182 | Carol R Harrus | Psychiatry & Neurology | 517 Patricia Ln, Palo Alto, CA 94303-2856 | 2017-02-25 |
| 1437539509 | Ehab Yacoub, Md Inc. | Psychiatry & Neurology | 1225 W 190th St Ste 470, Gardena, CA 90248-4316 | 2015-06-04 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
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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.