Healthcare Provider Details

I. General information

NPI: 1821948977
Provider Name (Legal Business Name): EVERHAVEN INTEGRATED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1673 LION ST
ROCKLIN CA
95765-5735
US

IV. Provider business mailing address

1673 LION ST
ROCKLIN CA
95765-5735
US

V. Phone/Fax

Practice location:
  • Phone: 408-668-4373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KRISTINE NICOLE M CHI
Title or Position: OWNER
Credential:
Phone: 408-668-4373