Basic Information
| Provider Information | |||||||||
| NPI: | 1154876654 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOSMAN-WIENER | ||||||||
| FirstName: | NAOMI | ||||||||
| MiddleName: | SARAH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | WRIGHT INSTITUTE CLINICAL SERVICES | ||||||||
| Address2: | 1918 UNIVERSITY AVENUE, SUITE 2B | ||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105489716 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1801 VICENTE ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941162923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159631258 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2016 | ||||||||
| LastUpdateDate: | 05/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | N | Other Service Providers | Community Health Worker | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.