Individual ProviderWanda Michelle CooperMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address17130 Sequoia Ave, Suite 103, Hesperia, CA 92395-1827(760) 949-1939PECOS EnrollmentBased on the most recent information from CMS, provider Wanda Michelle Cooper does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1770643348Provider TypeIndividualFull NameCooper, Wanda MichelleTitleMissGenderFemaleSole ProprietorNoEnumeration Date12/12/2006Last Updated5/12/2016Contact InformationPractice LocationPractice Address17130 Sequoia Ave, Suite 103, Hesperia, CA 92395-1827Phone(760) 949-1939Fax(760) 949-1970Mailing LocationMailing Address17130 Sequoia St, Suite 103, Hesperia, CA 92345-1403Phone(760) 949-1939Fax(760) 949-1970Provider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense50136California