Individual
RYAN MARTIN COPPAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7171 BOWLING DR STE 300, SACRAMENTO, CA 95823-2043
(916) 394-9195
Mailing address
4343 WILLIAMSBOURGH DR, SACRAMENTO, CA 95823
(916) 395-3552
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/09/2008
Last updated
06/20/2018
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