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XANDER JACK COOPER
NPI 1114403573
Marriage & Family Therapist in San Diego, CA

Active since July 18, 2018PECOS EnrolledAccepts Medicare Assignment
1202 MORENA BLVD STE 300, SAN DIEGO, CA 92110(619) 276-8112 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 9, 2022, Aug 1, 2018, Jul 18, 2018 (3 updates tracked since 2018).

About Xander Jack Cooper NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

XANDER JACK COOPER (NPI 1114403573) is an individual marriage & family therapist in San Diego, California, licensed in (130974) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1114403573
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameXANDER JACK COOPER
Location Address1202 MORENA BLVD STE 300San Diego, CA 92110-3844
Mailing Address1202 Morena Blvd Ste 300San Diego, CA 92110-3844 · (619) 276-8112
Phone(619) 276-8112
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJuly 18, 2018
Last NPPES UpdateMay 9, 20223 updates tracked since enumeration
NPPES CertifiedMay 9, 2022
✔ NPI 1114403573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed · 130974
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1202 MORENA BLVD STE 300, San Diego, CA 92110
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Xander Jack Cooper is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688013386
PECOS Enrollment IDI20240415001240
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Xander Cooper reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kab Medical Group Inc
12 mi
Psychiatry
765 THIRD AVE STE 100
Chula Vista, CA 91910
  • Reassigned Medicare billing, California enrollment
  • 11 clinicians in this Medicare group
NPI 1639634421 (619) 765-2684

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREA MARITZA AMAYA
Student in an Organized Health Care Education/Training Program
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 398-3261
JACOB WARNERS
Student in an Organized Health Care Education/Training Program
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 275-0822
JULIA A JONES RN
Counselor (Mental Health)
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 275-0822
GABRIELA CONTRERAS NAVARRO LMFT
Marriage & Family Therapist
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 276-8112
CHEYENNE BARTRAM
Day Training/Habilitation Specialist
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 275-0822
NICOLE K HEESEN
Counselor (Mental Health)
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 275-0822
MISS MONIQUE HOPE GUERRERO
Counselor (Mental Health)
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 275-0823
ANETTE RUIZ LMFT
Marriage & Family Therapist
1202 MORENA BLVD STE 300
SAN DIEGO, CA 92110
San Diego County (619) 276-8112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Xander Cooper's NPI number?

The NPI number for Xander Cooper is 1114403573. It was assigned to this individual provider in the NPPES registry on July 18, 2018.

Where is Xander Cooper located?

Xander Cooper practices at 1202 Morena Blvd Ste 300, San Diego, CA 92110. The listed phone number is (619) 276-8112.

What is Xander Cooper's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Xander Cooper enrolled in Medicare?

Yes. Xander Cooper is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Xander Cooper's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Xander Cooper reassigns Medicare benefits to Kab Medical Group Inc (Chula Vista, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Xander Cooper's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Xander Cooper was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.