Healthcare Provider Details

I. General information

NPI: 1457533788
Provider Name (Legal Business Name): MS. ELEANOR VOHRYZEK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 24TH ST
RICHMOND CA
94804-1804
US

IV. Provider business mailing address

15 CHRISTIANSEN LN
WALNUT CREEK CA
94597-2647
US

V. Phone/Fax

Practice location:
  • Phone: 510-374-3420
  • Fax:
Mailing address:
  • Phone: 925-256-0198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC33955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: