Healthcare Provider Details

I. General information

NPI: 1831040567
Provider Name (Legal Business Name): NOAH SHEM KLEIN MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 RED HILL AVE STE 5
SAN ANSELMO CA
94960-2468
US

IV. Provider business mailing address

412 RED HILL AVE STE 5
SAN ANSELMO CA
94960-2468
US

V. Phone/Fax

Practice location:
  • Phone: 415-987-4056
  • Fax:
Mailing address:
  • Phone: 415-987-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT133976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: