Provider Demographics
NPI:1609560697
Name:VEDAR, EVELYN NIEVES (LMFT)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:NIEVES
Last Name:VEDAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28039 SCOTT RD. SUITE D#128
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-7430
Mailing Address - Country:US
Mailing Address - Phone:424-239-9528
Mailing Address - Fax:
Practice Address - Street 1:33735 VERBENA AVE
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-4413
Practice Address - Country:US
Practice Address - Phone:424-239-9528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126538106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist