Healthcare Provider Details

I. General information

NPI: 1851863278
Provider Name (Legal Business Name): APRIL COOK SURAVALLOP LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2018
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 SOLANO AVE APT 303
BERKELEY CA
94707-2104
US

IV. Provider business mailing address

1685 SOLANO AVE APT 303
BERKELEY CA
94707-2104
US

V. Phone/Fax

Practice location:
  • Phone: 510-730-0296
  • Fax:
Mailing address:
  • Phone: 510-730-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163626
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: