Provider Demographics
NPI:1144547993
Name:KORNFELD, MEREDITH
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:
Last Name:KORNFELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CHANNING WAY
Mailing Address - Street 2:APT. 170
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2640
Mailing Address - Country:US
Mailing Address - Phone:415-464-9535
Mailing Address - Fax:
Practice Address - Street 1:1251 S ELISEO DR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2005
Practice Address - Country:US
Practice Address - Phone:415-924-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist