KATHLEEN M HERZOG
NPI 1487381422
Student in an Organized Health Care Education/Training Program in San Rafael, CA

Active since August 01, 2022PECOS Enrolled
3270 KERNER BLVD, SAN RAFAEL, CA 94901(415) 473-4059 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kathleen M Herzog NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN M HERZOG (NPI 1487381422) is an individual student in an organized health care education/training program in San Rafael, California and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1487381422
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKATHLEEN M HERZOG
Location Address3270 KERNER BLVDSan Rafael, CA 94901-4840
Mailing Address145 Corte Madera Town Ctr # 210Corte Madera, CA 94925-1209 · (415) 987-6004
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 1, 2022
NPPES CertifiedAugust 1, 2022
NPI 1487381422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3270 KERNER BLVD, San Rafael, CA 94901

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kathleen M Herzog is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608384581
PECOS Enrollment IDI20250801003146
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
3270 KERNER BLVD, BUILDING A, STE C
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Social Worker
3270 KERNER BLVD, SUITE A
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Psychologist
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Nurse Practitioner (Psychiatric/Mental Health)
3270 KERNER BLVD, SUITE B
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Psychiatry & Neurology (Psychiatry)
3270 KERNER BLVD
SAN RAFAEL, CA 94901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathleen Herzog's NPI number?

The NPI number for Kathleen Herzog is 1487381422. It was assigned to this individual provider in the NPPES registry on August 1, 2022.

Where is Kathleen Herzog located?

Kathleen Herzog practices at 3270 Kerner Blvd, San Rafael, CA 94901. The listed phone number is (415) 473-4059.

What is Kathleen Herzog's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kathleen Herzog enrolled in Medicare?

Yes. Kathleen Herzog is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathleen Herzog was last updated on August 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.