Provider Demographics
NPI:1093037509
Name:KOHS, KRISTIN ANNE-MARIE (CMT, HE)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ANNE-MARIE
Last Name:KOHS
Suffix:
Gender:F
Credentials:CMT, HE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3857 PALMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-2646
Mailing Address - Country:US
Mailing Address - Phone:510-375-0071
Mailing Address - Fax:
Practice Address - Street 1:3857 PALMWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-2646
Practice Address - Country:US
Practice Address - Phone:510-375-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000038014174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator