Provider Demographics
NPI:1265833065
Name:COOPER, KARINA (LMFT)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:MARQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1630 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5204
Mailing Address - Country:US
Mailing Address - Phone:833-579-4848
Mailing Address - Fax:
Practice Address - Street 1:730 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6618
Practice Address - Country:US
Practice Address - Phone:619-591-5740
Practice Address - Fax:619-591-5744
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA145199106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist