Healthcare Provider Details

I. General information

NPI: 1245190354
Provider Name (Legal Business Name): VICTORIA S MAKOL MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 10/09/2026
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEARWATER COUNSELING & ASSESSMENT SERVICES 1 BATES BLVD, STE 400
ORINDA CA
94563-2800
US

IV. Provider business mailing address

CLEARWATER COUNSELING & ASSESSMENT SERVICES 1 BATES BLVD, STE 400
ORINDA CA
94563-2800
US

V. Phone/Fax

Practice location:
  • Phone: 510-596-8137
  • Fax: 510-596-8955
Mailing address:
  • Phone: 510-596-8137
  • Fax: 510-596-8955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT157261
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: