Provider Demographics
NPI:1790836591
Name:SCHOEN, KITSY (MSW)
Entity Type:Individual
Prefix:MS
First Name:KITSY
Middle Name:
Last Name:SCHOEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:SCHOEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:280 W MACARTHUR BLVD
Mailing Address - Street 2:3900
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5642
Mailing Address - Country:US
Mailing Address - Phone:510-752-7983
Mailing Address - Fax:
Practice Address - Street 1:280 W MACARTHUR BLVD
Practice Address - Street 2:3900
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5642
Practice Address - Country:US
Practice Address - Phone:510-752-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 120711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical