Provider Demographics
NPI:1356870315
Name:COHEN, AYELET (NP)
Entity type:Individual
Prefix:
First Name:AYELET
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 PARK VIEW TER APT 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4646
Mailing Address - Country:US
Mailing Address - Phone:240-691-7647
Mailing Address - Fax:
Practice Address - Street 1:333 PARK VIEW TER APT 2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4646
Practice Address - Country:US
Practice Address - Phone:240-691-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF03170159363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF03170159OtherFAMILY NURSE PRACTITIONER