Provider Demographics
NPI:1275055253
Name:COFER, OPHELIA RAQUEL (ASW)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:RAQUEL
Last Name:COFER
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N VILLA AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOWS
Mailing Address - State:CA
Mailing Address - Zip Code:95988-2641
Mailing Address - Country:US
Mailing Address - Phone:530-934-6582
Mailing Address - Fax:
Practice Address - Street 1:242 N VILLA AVE
Practice Address - Street 2:
Practice Address - City:WILLOWS
Practice Address - State:CA
Practice Address - Zip Code:95988-2641
Practice Address - Country:US
Practice Address - Phone:530-685-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1048971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical