Healthcare Provider Details

I. General information

NPI: 1306760517
Provider Name (Legal Business Name): DR. KLAUS POPPENSIEKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 FORREST ST
MILL VALLEY CA
94941-2003
US

IV. Provider business mailing address

34 FORREST ST
MILL VALLEY CA
94941-2003
US

V. Phone/Fax

Practice location:
  • Phone: 831-345-9592
  • Fax:
Mailing address:
  • Phone: 831-345-9592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: