Individual
WILLIE JAMES COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 23RD ST, RICHMOND, CA 94804-1338
(510) 229-5000
(510) 235-3112
Mailing address
171 S 42ND ST, RICHMOND, CA 94804-3423
(510) 215-0605
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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