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NPI Code Detail

MEDICARE: EVYENIA MIRIANTHI MYLORDOS AMFT

MEDICARE: EVYENIA MIRIANTHI MYLORDOS AMFT
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
1106H00000XMarriage & Family TherapistAMFT159661CA

General Provider Information

NPI Number : 1790510501
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVYENIA MIRIANTHI MYLORDOS AMFT
Provider Business Mailing Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-268-3770
Fax Number :
Provider Business Practice Location Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-268-3770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2024
Last Update Date : 01/16/2026

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Directions to “ EVYENIA MIRIANTHI MYLORDOS AMFT” Practice Location

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