Healthcare Provider Details

I. General information

NPI: 1932929882
Provider Name (Legal Business Name): RIANN KOPCHAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 SUNSET AVE STE 200
SUISUN CITY CA
94585-2003
US

IV. Provider business mailing address

333 SUNSET AVE STE 200
SUISUN CITY CA
94585-2003
US

V. Phone/Fax

Practice location:
  • Phone: 707-225-7899
  • Fax: 707-759-3810
Mailing address:
  • Phone: 707-225-7899
  • Fax: 707-759-3810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number18013
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number150595
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150595
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: