Provider Demographics
NPI:1235419722
Name:COOKS, ALEANTHEA (MD)
Entity Type:Individual
Prefix:MS
First Name:ALEANTHEA
Middle Name:
Last Name:COOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:THEA
Other - Middle Name:
Other - Last Name:C
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 12365
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-2442
Mailing Address - Country:US
Mailing Address - Phone:909-332-2265
Mailing Address - Fax:
Practice Address - Street 1:1991 CENTRAL AVE
Practice Address - Street 2:STE 3
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-2442
Practice Address - Country:US
Practice Address - Phone:909-332-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138707156FC0801X, 156FX1800X
CA246YC3301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Yes156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital Based