Healthcare Provider Details

I. General information

NPI: 1497360036
Provider Name (Legal Business Name): EMILY ELIZABETH COPLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E RINCON ST STE 219
CORONA CA
92879-1387
US

IV. Provider business mailing address

10511 LINDESMITH AVE
WHITTIER CA
90603-2618
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-4453
  • Fax:
Mailing address:
  • Phone: 714-315-8612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-43641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: