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General NPI Number Information
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NPI Number | 1881723575
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Entity Type | Individual
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Provider Name | EVELYN S SHAFNER MFC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 173 S ORANGE DR
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City | LOS ANGELES
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State | CA
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Zip | 90036-3012
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Country | US
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Telephone | 323-931-5042
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Fax | 323-525-0424
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Provider Business Mailing Address
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Address Line | 173 S. ORANGE DRIVE
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City | LOS ANGELES
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State | CA
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Zip | 90036
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Country | US
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Telephone | 323-936-9231
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Fax | 323-525-0424
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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 | MFC13554
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License Number State | CA
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