Healthcare Provider Details

I. General information

NPI: 1114236320
Provider Name (Legal Business Name): YVETTE SOPHIA TOVAR M.S., M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W 17TH ST BLDG #50
SANTA ANA CA
92706-2316
US

IV. Provider business mailing address

1725 W 17TH ST BLDG #50
SANTA ANA CA
92706-2316
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-8565
  • Fax: 714-834-8395
Mailing address:
  • Phone: 714-834-8565
  • Fax: 714-834-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 45883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: