Provider Demographics
NPI:1699807628
Name:EIZNER, EDUARDO ADRIAN SR (MFT)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:ADRIAN
Last Name:EIZNER
Suffix:SR
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAPLE ST STE C
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3249
Mailing Address - Country:US
Mailing Address - Phone:831-595-2074
Mailing Address - Fax:
Practice Address - Street 1:11 MAPLE ST STE C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3249
Practice Address - Country:US
Practice Address - Phone:831-595-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34292106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist