Healthcare Provider Details

I. General information

NPI: 1205285145
Provider Name (Legal Business Name): EMILY EYERLY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31181 OLD RIVER RD
BONSALL CA
92003-5104
US

IV. Provider business mailing address

31181 OLD RIVER RD
BONSALL CA
92003-5104
US

V. Phone/Fax

Practice location:
  • Phone: 442-500-4419
  • Fax:
Mailing address:
  • Phone: 442-500-4419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT106319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: