Provider Demographics
NPI:1346894193
Name:COHN, KRISTIN CAROLINE ALEXANDRA
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:CAROLINE ALEXANDRA
Last Name:COHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 SHATTUCK AVE APT A
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1265
Mailing Address - Country:US
Mailing Address - Phone:707-590-2224
Mailing Address - Fax:
Practice Address - Street 1:365 FULTON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4489
Practice Address - Country:US
Practice Address - Phone:415-857-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program