Healthcare Provider Details

I. General information

NPI: 1972011096
Provider Name (Legal Business Name): C.O.P.E. FAMILY SUPPORT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 CITRUS CIR STE 180
WALNUT CREEK CA
94598-2675
US

IV. Provider business mailing address

3021 CITRUS CIR STE 105
WALNUT CREEK CA
94598-2643
US

V. Phone/Fax

Practice location:
  • Phone: 925-689-5811
  • Fax:
Mailing address:
  • Phone: 925-689-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NATASHA PADDOCK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 925-689-5811