Provider Demographics
NPI:1902973340
Name:KOPEL, REID JONATHAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:JONATHAN
Last Name:KOPEL
Suffix:
Gender:M
Credentials:PHD
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Other - First Name:
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Mailing Address - Street 1:7601 STONERIDGE DR
Mailing Address - Street 2:DEPT OF PSYCHIATRY
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4501
Mailing Address - Country:US
Mailing Address - Phone:925-857-5453
Mailing Address - Fax:925-847-5628
Practice Address - Street 1:7601 STONERIDGE DR
Practice Address - Street 2:DEPT OF PSYCHIATRY
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4501
Practice Address - Country:US
Practice Address - Phone:925-857-5453
Practice Address - Fax:925-847-5628
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 9820103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist