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Individual

CHERIE L COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
8120 TIMBERLAKE WAY, STE 101, SACRAMENTO, CA 95823-5412
(916) 423-2124
(916) 423-2127
Mailing address
8120 TIMBERLAKE WAY, STE 101, SACRAMENTO, CA 95823-5412
(916) 423-2124
(916) 423-2127

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14964
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14964
RN
CA
01
CT709Z
MEDICARE PROVIDER NUMBER--PTAN
CA
05
ZZZ03024Z
CA
05
ZZZ80876Z
CA
Enumeration date
09/11/2009
Last updated
03/04/2010
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