MICHELLE EILEEN KOPERSKI (NPI# 1619589140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619589140 |
| Entity Type | Individual |
| Full Name | MICHELLE EILEEN KOPERSKI |
| Other Name | MICHELLE EILEEN CHAVEZ |
| Practice Address |
1481 Windsor Dr San Bernardino CA 92404-5416 |
| Mailing Address |
1022 Jonabell Way Beaumont CA 92223-7055 |
| Practice Telephone | 9093616470 |
| Practice Fax Number | 9092037403 |
| Mailing Telephone | 9512327930 |
| Mailing Fax Number | 9092037403 |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1481 WINDSOR DR |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-5416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104950310 | Heather Rene Brown | Counselor | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2007-03-16 |
| 1578170650 | Nancy Elizabeth Ashcraft | Licensed Vocational Nurse | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-09-23 |
| 1598370918 | Jesse Daniel Rodriguez | Case Manager/Care Coordinator | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-09-11 |
| 1508480583 | Richard Anthony Delarosa | Counselor | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-06-04 |
| 1255955324 | Brenda A Aguayo | Counselor | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-06-03 |
| 1053935353 | Divina Elise Perez | Counselor | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-06-02 |
| 1538782917 | Rochelle Renee Knight | Licensed Vocational Nurse | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-05-20 |
| 1609497098 | Martin E Torres | Licensed Vocational Nurse | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-04-27 |
| 1508493495 | Ebony Rene Venable | Licensed Psychiatric Technician | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-03-23 |
| 1316572274 | Dana Dietz | Licensed Vocational Nurse | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2020-03-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437783180 | Samuel Guadron Rosales | Peer Specialist | 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 | 2020-03-02 |
| 1518502301 | Georgina Centeno | Peer Specialist | 780 Esat Gilbert St, San Bernardino, CA 92415-0001 | 2019-11-15 |
| 1063920973 | Arneta Brown | Peer Specialist | 658 E Brier Dr, San Bernardino, CA 92415-0928 | 2018-01-12 |
| 1518598879 | Denise Ybarra | Peer Specialist | 104 W 4th St, San Bernardino, CA 92415-0035 | 2020-01-27 |
| 1649818055 | Sidney Untal Suarez Jr. | Peer Specialist | 820 E Gilbert St, San Bernardino, CA 92415-0928 | 2019-12-16 |
| 1912543760 | Elsie Renee Rollins | Peer Specialist | 1481 Windsor Dr, San Bernardino, CA 92404-5416 | 2019-11-26 |
| 1841836145 | Noe Zepeda | Peer Specialist | 351 N Mt View Ave, San Bernardino, CA 92415-0001 | 2019-11-21 |
| 1265077341 | Demario O'ryan Dunn | Peer Specialist | 820 E Gilbert St, San Bernardino, CA 92415-1403 | 2019-11-12 |
| 1740825827 | Cristina Guerra | Peer Specialist | 820 E Gilbert St, San Bernardino, CA 92415-1403 | 2019-11-12 |
| 1063057149 | Derrick Cannon I | Peer Specialist | 820 E Gilbert St, San Bernardino, CA 92415-1403 | 2019-11-12 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
Please comment or provide details below to improve the information on MICHELLE EILEEN KOPERSKI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.