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General NPI Number Information
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NPI Number | 1104344126
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Entity Type | Individual
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Provider Name | ANGELA RENEE SPLANE COOPER
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 333 S BEAUDRY AVE
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City | LOS ANGELES
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State | CA
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Zip | 90017-1466
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Country | US
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Telephone | 213-241-3841
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Fax | 213-241-3305
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Provider Business Mailing Address
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Address Line | 501 SHATTO PL # 830
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City | LOS ANGELES
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State | CA
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Zip | 90020-1738
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Country | US
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Telephone | 213-351-5507
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Fax | 323-290-2359
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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