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General NPI Number Information
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NPI Number | 1568055218
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Entity Type | Organization
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Legal Business Name | EVERSON PSYCHOTHERAPY, INC.
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Dates
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Enumeration Date | 02/13/2021
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 8037 FAIR OAKS BLVD STE 112
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City | CARMICHAEL
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State | CA
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Zip | 95608-6742
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Country | US
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Telephone | 916-905-3395
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Fax | 916-905-0315
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Provider Business Mailing Address
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Address Line | 8037 FAIR OAKS BLVD STE 112
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City | CARMICHAEL
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State | CA
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Zip | 95608-6742
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Country | US
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Telephone | 916-905-3395
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Fax | 916-905-0315
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL EVERSON
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Credential | LMFT
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Telephone | 916-905-3395
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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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