Basic Information
| Provider Information | |||||||||
| NPI: | 1184246217 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | BRITTNEY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 512 27TH AVE APT 2 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941212866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059680845 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 39201 STATE ST | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945381437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662062008 | ||||||||
| FaxNumber: | 8663171665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2020 | ||||||||
| LastUpdateDate: | 05/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP23277 | CA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.