Provider Demographics
NPI:1639215387
Name:KOPEIKIN, HAL S (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:S
Last Name:KOPEIKIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 STATE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-5502
Mailing Address - Country:US
Mailing Address - Phone:805-886-0007
Mailing Address - Fax:
Practice Address - Street 1:735 STATE ST STE 206
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5502
Practice Address - Country:US
Practice Address - Phone:805-886-0007
Practice Address - Fax:805-886-0007
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2014-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9819103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
770572526OtherFEDERAL TIN