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General NPI Number Information
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NPI Number | 1619023264
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Entity Type | Individual
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Provider Name | ANNE KOPP PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 BICENTENNIAL WAY SUITE 270
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City | SANTA ROSA
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State | CA
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Zip | 95403-2192
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Country | US
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Telephone | 707-571-3113
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Fax | 707-571-4346
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Provider Business Mailing Address
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Address Line | 320 JUDAH ST SUITE 6
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2400
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Country | US
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Telephone | 415-681-7670
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Fax | 415-753-0200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 9656
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License Number State | CA
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