Provider Demographics
NPI:1194092163
Name:COOPER, SARAH (COMMUNITY WORKER)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:COMMUNITY WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-2973
Mailing Address - Country:US
Mailing Address - Phone:408-891-1337
Mailing Address - Fax:
Practice Address - Street 1:544 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-2973
Practice Address - Country:US
Practice Address - Phone:408-891-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker