| NPI | 1174297220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE KOCEN Credentialing 415-851-0195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 207R00000X Internal Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2022-05-12 |