Healthcare Provider Details

I. General information

NPI: 1023973252
Provider Name (Legal Business Name): WOMEN'S AND CHILDREN'S HEALTH CA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 LAS GALLINAS AVE STE 105
SAN RAFAEL CA
94903-3431
US

IV. Provider business mailing address

4701 SANGAMORE RD STE N100
BETHESDA MD
20816-2558
US

V. Phone/Fax

Practice location:
  • Phone: 914-919-9200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ISABELLE VON KOHORN
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 914-919-9200