Healthcare Provider Details

I. General information

NPI: 1255481610
Provider Name (Legal Business Name): EVA MARIE MARCELLI M.A. LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8802 CARLTON OAKS DR
SANTEE CA
92071-2305
US

IV. Provider business mailing address

8802 CARLTON OAKS DR
SANTEE CA
92071-2305
US

V. Phone/Fax

Practice location:
  • Phone: 858-247-9970
  • Fax:
Mailing address:
  • Phone: 858-247-9970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number44564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: