Provider Demographics
NPI:1770651986
Name:HAWKINS, EVAN RICHARD (MA, MFT)
Entity Type:Individual
Prefix:MR
First Name:EVAN
Middle Name:RICHARD
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N SEPULVEDA BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6850
Mailing Address - Country:US
Mailing Address - Phone:310-906-0571
Mailing Address - Fax:
Practice Address - Street 1:111 N SEPULVEDA BLVD STE 250
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6850
Practice Address - Country:US
Practice Address - Phone:310-906-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist