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KIMBERLY COPPAGE

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1356649438

Individual Registrant:
 KIMBERLY  COPPAGE 
Gender: F
Sole Proprietor

Location and contact information for practice:
68-625 PEREZ RD 11-A CATHEDRAL CITY, CA 92234 US
Tel: 760-773-6767  Fax: --

Contact information for business:
769 W BLAINE ST SUITE A RIVERSIDE, CA 92507-3970 US
Tel: 951-358-5186  Fax: --

Registration Information:
NPI: 1356649438
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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