Healthcare Provider Details

I. General information

NPI: 1619010055
Provider Name (Legal Business Name): MS. JANA KRISTINE COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3947 LENNANE DR STE 200
SACRAMENTO CA
95834-1973
US

IV. Provider business mailing address

1256 EL ENCANTO WAY
SACRAMENTO CA
95831-3123
US

V. Phone/Fax

Practice location:
  • Phone: 916-368-5948
  • Fax:
Mailing address:
  • Phone: 916-427-7141
  • Fax: 916-427-7122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number522486
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: