Provider Demographics
NPI:1710171012
Name:KOPMAN, MARINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:KOPMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 HOWARD ST
Mailing Address - Street 2:# 410
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-1611
Mailing Address - Country:US
Mailing Address - Phone:415-205-8681
Mailing Address - Fax:
Practice Address - Street 1:1939 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2507
Practice Address - Country:US
Practice Address - Phone:415-205-8681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23653103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical