Provider Demographics
NPI:1417007360
Name:KAUFMAN, CAROLYN A (RN CNS MFT)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:A
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:RN CNS MFT
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:KAUFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CNS MFT
Mailing Address - Street 1:1520 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2525
Mailing Address - Country:US
Mailing Address - Phone:415-355-8300
Mailing Address - Fax:415-861-5395
Practice Address - Street 1:1520 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2525
Practice Address - Country:US
Practice Address - Phone:415-355-8300
Practice Address - Fax:415-861-5395
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25267106H00000X
CA301287163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult