Healthcare Provider Details

I. General information

NPI: 1275450264
Provider Name (Legal Business Name): ABRAHAM P COHEN CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E LAUREL ST
FORT BRAGG CA
95437-3817
US

IV. Provider business mailing address

840 E LAUREL ST
FORT BRAGG CA
95437-3817
US

V. Phone/Fax

Practice location:
  • Phone: 707-694-3691
  • Fax:
Mailing address:
  • Phone: 707-694-3691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number99275
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: