Active NPI
Uri Elie Cohen, M.D.
- Child & Adolescent Psychiatry Physician
- San Rafael, CA
National Provider Identifier
1396964532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- A104583
- Practice address
- 3230 Kerner Blvd
San Rafael, CA 94901-4840 - Phone
- (415) 473-7249
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 241902 | NY | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | A104583 | CA | Primary |
Addresses
Primary practice location
3230 Kerner Blvd
San Rafael, CA 94901-4840
Mailing address
2050 Fairmont Dr
San Leandro, CA 94578-1001
Phone (415) 473-7249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104583 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 241902 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocketship Education Wisconsin Inc. | Past | Accepting new patients | |
| Seneca Family of Agencies | Past | Accepting new patients | |
| Seneca Family of Agencies | Past | Accepting new patients | |
| Seneca Center | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Fairfield, CA
- NPI 1699972281
-
- Community/Behavioral Health Agency
- Anaheim, CA
- NPI 1174801690
-
- Community/Behavioral Health Agency
- Santa Rosa, CA
- NPI 1205152733
-
- Local Education Agency (LEA)
- Milwaukee, WI
- NPI 1275964025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475193600000",
"number": "1396964532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 FAIRMONT DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781001",
"telephone_number": "415-473-7249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230 KERNER BLVD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949014840",
"telephone_number": "415-473-7249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "URI",
"middle_name": "ELIE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2016-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "241902",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A104583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.