Healthcare Provider Details

I. General information

NPI: 1003006784
Provider Name (Legal Business Name): VERONICA YVETTE EPHRAIM M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA YVETTE MONTES M.S.

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15250 AVENUE OF SCIENCE
SAN DIEGO CA
92128-3406
US

IV. Provider business mailing address

1202 MORENA BLVD STE 300
SAN DIEGO CA
92110-3844
US

V. Phone/Fax

Practice location:
  • Phone: 858-668-4087
  • Fax:
Mailing address:
  • Phone: 619-398-3261
  • Fax: 619-275-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number53434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: