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NPI Code Detail

MEDICARE: MS. LISA SUSAN COOPER

MEDICARE:  MS. LISA SUSAN COOPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerASW16007CA

General Provider Information

NPI Number : 1265508436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA SUSAN COOPER
Provider Business Mailing Address
First Line : 939 MARKET ST
Second Line : 4TH FLOOR
City : SAN FRANCISCO
State : CA
Zip : 94103-1706
Country : US
Telephone Number : 415-597-8117
Fax Number :
Provider Business Practice Location Address
First Line : 939 MARKET ST
Second Line : 4TH FLOOR
City : SAN FRANCISCO
State : CA
Zip : 94103-1706
Country : US
Telephone Number : 415-597-8117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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Directions to “ MS. LISA SUSAN COOPER ” Practice Location

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