Healthcare Provider Details

I. General information

NPI: 1982437042
Provider Name (Legal Business Name): EVER AFTER INDIVIDUAL AND FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 SAN RAMON VALLEY BLVD # 4180
SAN RAMON CA
94583-5381
US

IV. Provider business mailing address

2415 SAN RAMON VALLEY BLVD # 4180
SAN RAMON CA
94583-5381
US

V. Phone/Fax

Practice location:
  • Phone: 925-302-6071
  • Fax:
Mailing address:
  • Phone: 925-302-6071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KIRA TORRE
Title or Position: OWNER/CHIEF CLINICAL OFFICER
Credential: LMFT
Phone: 925-302-6071