Basic Information
| Provider Information | |||||||||
| NPI: | 1497360036 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COPLEY | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10511 LINDESMITH AVE | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906032618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143158612 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1063 MCGAW AVE | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926145505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149224453 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2020 | ||||||||
| LastUpdateDate: | 09/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-20-43641 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.