MEDICARE: DR. KAREN BRONK FROMING PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	11421	CA
2	103TC0700X	Clinical Psychologist	11421	CA
3	103TF0200X	Forensic Psychologist	11421	CA

General Provider Information

NPI Number	:	1578778551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN BRONK FROMING PHD

Provider Business Mailing Address
First Line	:	175 VILLA TER
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-2213
Country	:	US
Telephone Number	:	415-621-8698
Fax Number	:	415-621-8696

Provider Business Practice Location Address
First Line	:	175 VILLA TER
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94114-2213
Country	:	US
Telephone Number	:	415-621-8698
Fax Number	:	415-621-8696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	09/11/2025

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