Provider Demographics
NPI:1295025005
Name:KOSTER, FELICITAS (DO)
Entity type:Individual
Prefix:MS
First Name:FELICITAS
Middle Name:
Last Name:KOSTER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8963 CAMINITO FRESCO
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 PINE ST STE 1250
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5235
Practice Address - Country:US
Practice Address - Phone:415-985-6697
Practice Address - Fax:888-815-3583
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0063212084P0800X
NY3285762084P0800X
390200000X
CA20A211022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program