Healthcare Provider Details

I. General information

NPI: 1902731920
Provider Name (Legal Business Name): HENRY J COHEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MAGNOLIA ST
SANTA CRUZ CA
95062-1504
US

IV. Provider business mailing address

130 MAGNOLIA ST
SANTA CRUZ CA
95062-1504
US

V. Phone/Fax

Practice location:
  • Phone: 202-494-3430
  • Fax:
Mailing address:
  • Phone: 202-494-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: