Provider Demographics
NPI:1083821912
Name:KEINS, JUDITH ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANNE
Last Name:KEINS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:520 TAMALPAIS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1558
Mailing Address - Country:US
Mailing Address - Phone:415-927-7213
Mailing Address - Fax:415-927-0949
Practice Address - Street 1:520 TAMALPAIS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1558
Practice Address - Country:US
Practice Address - Phone:415-927-7213
Practice Address - Fax:415-927-0949
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA417062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABK0925226OtherDEA REGISTRATION NUMBER