MEDICARE: ELIZABETH MYFANWY STEVENS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	88200	CA

General Provider Information

NPI Number	:	1285527366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MYFANWY STEVENS LMFT

Provider Business Mailing Address
First Line	:	23622 CALABASAS RD STE 240
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-4113
Country	:	US
Telephone Number	:	310-302-7110
Fax Number	:

Provider Business Practice Location Address
First Line	:	23622 CALABASAS RD STE 240
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-4113
Country	:	US
Telephone Number	:	310-302-7110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	11/02/2025

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