Provider Demographics
NPI:1801263595
Name:KAGAN, KARI (PSYD)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:KAGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:KAGAN
Other - Last Name:DORENBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:870 MARKET ST
Mailing Address - Street 2:STE. 377
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3099
Mailing Address - Country:US
Mailing Address - Phone:415-494-7041
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:STE. 377
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3099
Practice Address - Country:US
Practice Address - Phone:415-494-7041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27544103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical