RYAN MARTIN COPPAGE (NPI# 1720241847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720241847 |
| Entity Type | Individual |
| Full Name | RYAN MARTIN COPPAGE |
| Practice Address |
7171 Bowling Dr Ste 300 Sacramento CA 95823-2043 |
| Mailing Address |
4343 Williamsbourgh Dr Sacramento CA 95823 |
| Practice Telephone | 9163949195 |
| Mailing Telephone | 9163953552 |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2018-06-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4343 Williamsbourgh Dr, Sacramento, CA 95823 | 9163953552 |
| Street Address |
7171 BOWLING DR STE 300 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-2043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275613168 | Don Young | Psychiatry & Neurology | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2006-10-16 |
| 1801400593 | Sandra Feliz | Case Manager/Care Coordinator | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-09-01 |
| 1447864228 | Consumers Self Help | Marriage & Family Therapist | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-08-31 |
| 1851912232 | Tarah Taber | Case Manager/Care Coordinator | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-04-27 |
| 1235766585 | Maura Ellen Okeefe | Social Worker | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-03-26 |
| 1831721331 | Leshon Mitchell | Case Manager/Care Coordinator | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-02-12 |
| 1578195301 | Fanica Brintee Sims | Counselor | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-02-10 |
| 1750921110 | Jason Tyrone Cooper | Counselor | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-01-13 |
| 1730728130 | Tracy Lynn Bridges Sr. | Counselor | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2020-01-02 |
| 1720623895 | Pamela Sue Brookins | Case Manager/Care Coordinator | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2019-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639653264 | Angela Renee Sanders | Peer Specialist | 7171 Bowling Dr Ste 200, Sacramento, CA 95823-2034 | 2018-09-19 |
| 1750896288 | Wilfred Carnell Broom | Peer Specialist | 3321 Power Inn Rd Ste 10, Sacramento, CA 95826-3890 | 2017-12-06 |
| 1669925475 | Camelia Straughn | Peer Specialist | 1951 67th Ave, Sacramento, CA 95822-4826 | 2016-07-27 |
| 1114384831 | Kristen Bruno | Peer Specialist | 657 Jessie Ave, Sacramento, CA 95838-2610 | 2016-01-26 |
| 1386205227 | Cynthia Michelle Lozano | Peer Specialist | 650 Howe Ave Ste 400-a, Sacramento, CA 95825-4731 | 2019-06-21 |
| 1225598162 | Ralph Martha | Peer Specialist | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2019-03-25 |
| 1609335033 | Alison Elaine Barnard | Peer Specialist | 2130 Stockton Blvd Bldg 300, Sacramento, CA 95817-1337 | 2019-03-15 |
| 1982187597 | Almaruthe Condell | Peer Specialist | 650 Howe Ave Ste 400-a, Sacramento, CA 95825-4731 | 2018-09-10 |
| 1033604632 | Karen R Cameron | Peer Specialist | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2018-06-26 |
| 1730671843 | Gustavo Ayala | Peer Specialist | 7171 Bowling Dr Ste 300, Sacramento, CA 95823-2043 | 2018-06-04 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on RYAN MARTIN COPPAGE.
| 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.