Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen M Herzog

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1487381422

Kathleen M Herzog is a Clinical Psychologist in San Rafael, California. Qualified in 2023, 3 years ago. Registered with an NPI since 2022.

Years since qualifying
3
In the registry since
2022
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Practice location Address checks out

3270 Kerner Blvd
San Rafael, CA 94901-4840
Phone: (415) 473-4059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1487381422
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 1, 2022
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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