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General NPI Number Information
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NPI Number | 1609560697
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Entity Type | Individual
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Provider Name | EVELYN NIEVES VEDAR LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 33735 VERBENA AVE
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City | MURRIETA
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State | CA
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Zip | 92563-4413
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Country | US
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Telephone | 424-239-9528
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Fax |
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Provider Business Mailing Address
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Address Line | 28039 SCOTT RD. SUITE D#128
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City | MURRIETA
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State | CA
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Zip | 92563-7430
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Country | US
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Telephone | 424-239-9528
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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 | 126538
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License Number State | CA
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