Provider Demographics
NPI:1396943692
Name:KUSNIR, ROSARIO (MFT)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:KUSNIR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MARIA DEL
Other - Middle Name:ROSARIO
Other - Last Name:MURGA DEL VALLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 LAKESHORE AVE APT 18D
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-1629
Mailing Address - Country:US
Mailing Address - Phone:510-524-6166
Mailing Address - Fax:
Practice Address - Street 1:2315 PRINCE ST # 4
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1915
Practice Address - Country:US
Practice Address - Phone:510-524-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27905106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist