Provider Demographics
NPI:1124561444
Name:KUHN, ROGER J
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:J
Last Name:KUHN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 17TH ST APT 18
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1998
Mailing Address - Country:US
Mailing Address - Phone:415-347-5454
Mailing Address - Fax:
Practice Address - Street 1:2370 MARKET ST
Practice Address - Street 2:104
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1521
Practice Address - Country:US
Practice Address - Phone:415-347-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-19
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist