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General NPI Number Information
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NPI Number | 1376217307
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Entity Type | Organization
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Legal Business Name | CARRIE K. EVENDEN, PSY.D. PSYCHOTHERAPY CORPORATION
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 2441 FILLMORE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1814
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Country | US
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Telephone | 415-793-9643
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Fax |
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Provider Business Mailing Address
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Address Line | 2441 FILLMORE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1814
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Country | US
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Telephone | 415-793-9643
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. CARRIE KRISTEN EVENDEN
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Credential | PSY.D.
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Telephone | 415-793-9643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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