Healthcare Provider Details

I. General information

NPI: 1255783080
Provider Name (Legal Business Name): HANNAH ROWENA KOPP-YATES RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

4520 WEBSTER ST
OAKLAND CA
94609-2141
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-7575
  • Fax: 415-925-7604
Mailing address:
  • Phone: 510-289-6169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235831
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95091541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: