Provider Demographics
NPI:1154876654
Name:KOSMAN-WIENER, NAOMI SARAH (MA)
Entity type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:SARAH
Last Name:KOSMAN-WIENER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GOUGH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5971
Mailing Address - Country:US
Mailing Address - Phone:415-861-5449
Mailing Address - Fax:
Practice Address - Street 1:110 GOUGH ST STE 301
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5971
Practice Address - Country:US
Practice Address - Phone:415-861-5449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36157103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical