Provider Demographics
NPI:1578735924
Name:KOKOSKA, KIM A (MFT)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:A
Last Name:KOKOSKA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FRANCISCO ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-2122
Mailing Address - Country:US
Mailing Address - Phone:323-363-7837
Mailing Address - Fax:
Practice Address - Street 1:6221 GEARY BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1887
Practice Address - Country:US
Practice Address - Phone:323-363-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48409101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health