Provider Demographics
NPI:1336951656
Name:EV MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:EV MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIOLET
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-922-0983
Mailing Address - Street 1:1852 DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1924
Mailing Address - Country:US
Mailing Address - Phone:310-922-0983
Mailing Address - Fax:
Practice Address - Street 1:2931 SHATTUCK AVE STE D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1986
Practice Address - Country:US
Practice Address - Phone:510-214-3789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty