Individual
MR. JASON TYRONE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3628 MADISON AVE STE 7, NORTH HIGHLANDS, CA 95660-5070
(916) 840-1413
Mailing address
3628 MADISON AVE STE 7, NORTH HIGHLANDS, CA 95660-5070
(916) 567-4222
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
01/13/2020
Last updated
11/22/2022
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