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NPI Code Detail

MEDICARE: KOFI ISABELLA NEWSOME

MEDICARE: KOFI ISABELLA NEWSOME
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
1175T00000XPeer SpecialistMPSS-MHWJTCCA

General Provider Information

NPI Number : 1932032737
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOFI ISABELLA NEWSOME
Provider Business Mailing Address
First Line : 5055 REID CT
Second Line :
City : RICHMOND
State : CA
Zip : 94804-4404
Country : US
Telephone Number : 510-536-8111
Fax Number :
Provider Business Practice Location Address
First Line : 2633 E 27TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1912
Country : US
Telephone Number : 510-536-8111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ KOFI ISABELLA NEWSOME ” Practice Location

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