Healthcare Provider Details

I. General information

NPI: 1790612489
Provider Name (Legal Business Name): CHOLEE COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28184 CABRILLO LN
VALENCIA CA
91354-4902
US

IV. Provider business mailing address

28184 CABRILLO LN
VALENCIA CA
91354-4902
US

V. Phone/Fax

Practice location:
  • Phone: 323-547-0200
  • Fax:
Mailing address:
  • Phone: 323-547-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number6249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: