Healthcare Provider Details

I. General information

NPI: 1891599494
Provider Name (Legal Business Name): JESSICA KUHFAL M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
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: 510-412-9200
  • Fax: 510-412-9248
Mailing address:
  • Phone: 510-412-9200
  • Fax: 510-412-9248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: