Individual
AMI BEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 MARIA LN STE 300, WALNUT CREEK, CA 94596-5314
(510) 681-7409
Mailing address
1229 1/2 ROSE ST, CROCKETT, CA 94525-1362
(510) 681-7409
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
106805
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01111
—
CA
Enumeration date
01/12/2022
Last updated
05/18/2023
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