Healthcare Provider Details

I. General information

NPI: 1538068366
Provider Name (Legal Business Name): MAURA WONG WONG COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 STARBURST CT
WINDSOR CA
95492-8938
US

IV. Provider business mailing address

865 STARBURST CT
WINDSOR CA
95492-8938
US

V. Phone/Fax

Practice location:
  • Phone: 415-602-7751
  • Fax: 415-376-0849
Mailing address:
  • Phone: 415-602-7751
  • Fax: 415-376-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: