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General NPI Number Information
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NPI Number | 1063340917
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Entity Type | Organization
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Legal Business Name | EVARE PSYCHOLOGY, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 185 LAKE DR
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City | BOULDER CREEK
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State | CA
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Zip | 95006-9281
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Country | US
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Telephone | 650-223-5389
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Fax |
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Provider Business Mailing Address
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Address Line | 185 LAKE DR
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City | BOULDER CREEK
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State | CA
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Zip | 95006-9281
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Country | US
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Telephone | 650-223-5389
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENJAMIN EVARE
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Credential | PHD
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Telephone | 650-223-5389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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