Provider Demographics
NPI:1104327188
Name:YAPP-COOPER, KRISTA (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:YAPP-COOPER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 STRASBURG DR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-3303
Mailing Address - Country:US
Mailing Address - Phone:408-753-6097
Mailing Address - Fax:
Practice Address - Street 1:406 STRASBURG DR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-3303
Practice Address - Country:US
Practice Address - Phone:408-753-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY3831487OtherKAISER