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

Q: 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.

Q: What is Xander Cooper's specialty?

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

Q: 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.

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: August 09, 2026.

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

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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, and ordering and referring status from the CMS PECOS system.

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.

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.

MRS. VERONICA YVETTE EPHRAIM M.S.

Marriage & Family Therapist