JEROME ANTHONY COPPAGE JR. (NPI# 1780141630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780141630 |
| Entity Type | Individual |
| Full Name | JEROME ANTHONY COPPAGE JR. |
| Credential | RBT-16-4282-36534 |
| Practice Address |
30073 Via Amante Menifee CA 92584-8910 |
| Practice Telephone | 6198954615 |
| Mailing Telephone | 6198954615 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-16-4282-3653 | CA | Behavioral Health & Social Service Providers |
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
30073 VIA AMANTE |
| City | MENIFEE |
| State | CA |
| Zip Code | 92584-8910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467091249 | Christopher Aron Sanders | Family Medicine | 30243 Westlake Dr, Menifee, CA 92584 | 2019-12-27 |
| 1336619451 | Tricia Rose Fontanilla Alegado | Nurse Practitioner | 29740 Mesa Verde Cir, Menifee, CA 92584 | 2018-12-01 |
| 1548776446 | Nicole O'neil | Nurse Practitioner | 29826 Haun Rd Suite 300, Menifee, CA 92584 | 2017-12-14 |
| 1518485150 | Harvinder Singh | Driver | 31972 Ruxton St, Menifee, CA 92584 | 2017-09-04 |
| 1558884239 | Poulsen Dental Corporation | Dentist | 29121 Newport Road, Ste 1, Menifee, CA 92584 | 2017-07-25 |
| 1598200040 | Thay Kieu | Dental Hygienist | 30035 Haun Rd, Menifee, CA 92584 | 2016-12-19 |
| 1033668652 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 28995 Newport Road, Menifee, CA 92584 | 2016-09-23 |
| 1295187474 | Cohen Sedgh, Manavi & Pakravan Dental Corp | Dentist | 30035 Haun Road, Menifee, CA 92584 | 2016-07-12 |
| 1871965640 | Sharon D. Benjamin | Licensed Vocational Nurse | 29120 Bridgeport Lane, Menifee, CA 92584 | 2015-10-20 |
| 1538573175 | Edwin Haroldo Alvarez | Physician Assistant | 31216 Silver Moon Court, Menifee, CA 92584 | 2014-06-11 |
| Find all providers in zip 92584 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558975110 | Catherine Meneses | Behavior Technician | 29610 Longshore Dr, Menifee, CA 92585-9280 | 2020-09-01 |
| 1649802893 | Richard Juarez | Behavior Technician | 29828 Gifhorn Rd, Menifee, CA 92584-2600 | 2020-02-06 |
| 1982254298 | Gary Ray Rodriguez | Behavior Technician | 27808 Cloud Dance Ct, Menifee, CA 92585-9005 | 2019-09-18 |
| 1427603877 | Ashley Karina Perez | Behavior Technician | 28580 Rustic Glen St, Menifee, CA 92584-7320 | 2019-08-02 |
| 1043777428 | Kamber Marie Howard | Behavior Technician | 29146 Granite Cir, Menifee, CA 92584-7825 | 2019-02-21 |
| 1700392594 | Hedy H Dembowski | Behavior Technician | 26769 Calle Emiliano, Menifee, CA 92585-8836 | 2017-12-16 |
| 1346756236 | Jonita Joy Santorum | Behavior Technician | 29502 Moorings Ct, Menifee, CA 92585-9065 | 2017-12-14 |
| 1386180370 | Tanice Ellen Deguzman | Behavior Technician | 29207 Bay Bridge Court, Menifee, CA 92585 | 2017-01-13 |
| 1609476431 | Ana Luna Flores | Behavior Technician | 26900 Newport Rd Ste 111, Menifee, CA 92584-9224 | 2020-10-30 |
| 1336755818 | Alicia Morris | Behavior Technician | 26900 Newport Rd Ste 111, Menifee, CA 92584-9224 | 2020-09-19 |
| Find all providers in MENIFEE | ||||
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| 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.