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NPI Code Detail

MEDICARE: MR. EVAN STRAUSS MFT

MEDICARE: MR. EVAN STRAUSS MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC 41915CA

General Provider Information

NPI Number : 1205943016
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EVAN STRAUSS MFT
Provider Business Mailing Address
First Line : POBOX 456
Second Line :
City : NORTH SAN JUAN
State : CA
Zip : 95960
Country : US
Telephone Number : 530-292-3683
Fax Number :
Provider Business Practice Location Address
First Line : 24077 STATE HIGHWAY 49
Second Line :
City : NEVADA CITY
State : CA
Zip : 95959-8519
Country : US
Telephone Number : 530-265-9057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 07/08/2007

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