Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 19460 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 19460 | CA |
NPI | 1003039843 |
---|---|
Provider Name | Dr. Andrew Lowell Cooper |
First Address | San Diego, CA 92138-6489 |
Second Address | Chula Vista, CA 91911-1307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 21/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY194600 | (05) | CA |