Provider Demographics
NPI:1598431363
Name:WEINMAN, KRISTIN (BSW, RADT-1)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:BSW, RADT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 JUANITA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1736
Mailing Address - Country:US
Mailing Address - Phone:415-418-8962
Mailing Address - Fax:
Practice Address - Street 1:4049 MILLER WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1332
Practice Address - Country:US
Practice Address - Phone:916-451-9312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9756863OtherKAISER