Healthcare Provider Details

I. General information

NPI: 1558508127
Provider Name (Legal Business Name): JULIANE JOHANNA MARIA KOWSKI LCAT, MT-BC, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 24TH ST
RICHMOND CA
94804-1804
US

IV. Provider business mailing address

200 24TH ST
RICHMOND CA
94804-1804
US

V. Phone/Fax

Practice location:
  • Phone: 510-412-9214
  • Fax:
Mailing address:
  • Phone: 510-412-9214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000231
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number000231
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number000231
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: