Healthcare Provider Details

I. General information

NPI: 1417007360
Provider Name (Legal Business Name): CAROLYN A KAUFMAN RN CNS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLYN KAUFMAN RN CNS MFT

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 HOWARD ST
SAN FRANCISCO CA
94103-2525
US

IV. Provider business mailing address

1520 HOWARD ST
SAN FRANCISCO CA
94103-2525
US

V. Phone/Fax

Practice location:
  • Phone: 415-355-8300
  • Fax: 415-861-5395
Mailing address:
  • Phone: 415-355-8300
  • Fax: 415-861-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number25267
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number301287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: