Provider Demographics
NPI:1609174044
Name:KOBRIN, SHOSHANA (MFT)
Entity Type:Individual
Prefix:MS
First Name:SHOSHANA
Middle Name:
Last Name:KOBRIN
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 1:1232 RUNNING SPRINGS RD
Mailing Address - Street 2:#3
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-5242
Mailing Address - Country:US
Mailing Address - Phone:925-256-8503
Mailing Address - Fax:925-256-8503
Practice Address - Street 1:39 QUAIL CT
Practice Address - Street 2:#200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5566
Practice Address - Country:US
Practice Address - Phone:925-256-8503
Practice Address - Fax:925-256-8503
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 23716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist