| Doctor Name: | SARA KOENIG |
| NPI Number: | 1144475112 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 18577 |
| Business Practice Address: | 5 Bon Air Road Ste. 105 Larkspur, CA - 94939 |
| Business Phone Number: | 4154610440 |
| Business Fax Number: | 4154613792 |
| Mailing Address: | 5 Bon Air Road, Ste. 105 LARKSPUR |
| State: | CA |
| Postal Code: | 94939 |
| Phone Number: | 4154610440 |
| Fax Number: | 4154613792 |
| NPI Enumeration Date: | 11/18/2008 |
| NPI Last Update Date: | 12/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 18577 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |