Provider Demographics
NPI:1598856247
Name:COOPER, SHARON BERNADETTE (CCRN, MSN, PNP, CNS)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:BERNADETTE
Last Name:COOPER
Suffix:
Gender:F
Credentials:CCRN, MSN, PNP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1931 W 94TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-3762
Mailing Address - Country:US
Mailing Address - Phone:310-423-4178
Mailing Address - Fax:310-423-0490
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:PICU, RM 4201
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-423-4178
Practice Address - Fax:310-423-0490
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA467558163W00000X, 163WC0200X, 163WP0200X
CA13023363LP0200X, 363LP0222X
CA2467364S00000X, 364SC0200X, 364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics