Provider Demographics
NPI:1750042198
Name:WEFERS, VERONICA CERVANTES (LMFT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:CERVANTES
Last Name:WEFERS
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:PO BOX 1211
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94942-1211
Mailing Address - Country:US
Mailing Address - Phone:415-806-3565
Mailing Address - Fax:
Practice Address - Street 1:205 CAMINO ALTO CT STE 120
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-4312
Practice Address - Country:US
Practice Address - Phone:415-806-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health