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General NPI Number Information
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NPI Number | 1427422880
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Entity Type | Individual
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Provider Name | YAMONTE COOPER
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Gender | Male
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 1923 1/2 WESTWOOD BLVD STE 2
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 424-272-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 10736 JEFFERSON BLVD # 175
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City | CULVER CITY
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State | CA
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Zip | 90230-4933
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Country | US
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Telephone | 424-272-0376
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Fax |
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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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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3666
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3666
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License Number State | CA
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