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General NPI Number Information
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NPI Number | 1023417375
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Entity Type | Individual
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Provider Name | JAMES EUBANKS MFT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1955 CLEVELAND AVE STE 205
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City | SANTA ROSA
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State | CA
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Zip | 95401-4282
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Country | US
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Telephone | 707-723-2570
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Fax |
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Provider Business Mailing Address
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Address Line | 444 N WASHINGTON ST
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City | CLOVERDALE
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State | CA
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Zip | 95425-3237
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Country | US
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Telephone | 707-616-4578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 124393
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License Number State | CA
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