Provider Demographics
NPI:1497898720
Name:COHEN, SUSAN B (MARRIAGE FAMILY THER)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:COHEN
Suffix:
Gender:F
Credentials:MARRIAGE FAMILY THER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 CAMINO DIABLO
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3962
Mailing Address - Country:US
Mailing Address - Phone:925-939-8765
Mailing Address - Fax:
Practice Address - Street 1:2940 CAMINO DIABLO
Practice Address - Street 2:SUITE 300
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-3962
Practice Address - Country:US
Practice Address - Phone:925-939-8765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT23583106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist