Provider Demographics
NPI:1962839647
Name:COHEN, JAMIE ALEXIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ALEXIS
Last Name:COHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:ALEXIS
Other - Last Name:RATNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1825 4TH ST
Mailing Address - Street 2:BOX 1948
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2350
Mailing Address - Country:US
Mailing Address - Phone:415-353-7574
Mailing Address - Fax:
Practice Address - Street 1:1825 4TH ST
Practice Address - Street 2:BOX 1948
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2350
Practice Address - Country:US
Practice Address - Phone:415-353-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25885103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25885OtherCALIFORNIA BOARD OF PSYCHOLOGY