Provider Demographics
NPI:1528568268
Name:KOGAN, ANYA V (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANYA
Middle Name:V
Last Name:KOGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:POVZNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 11TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2167
Mailing Address - Country:US
Mailing Address - Phone:415-595-9314
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 953
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2912
Practice Address - Country:US
Practice Address - Phone:415-761-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29806103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical