Provider Demographics
NPI:1780735472
Name:ZULUETA, EVELYNE TEEHANKEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:EVELYNE
Middle Name:TEEHANKEE
Last Name:ZULUETA
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 1:2926 LONE TREE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4924
Mailing Address - Country:US
Mailing Address - Phone:925-451-4724
Mailing Address - Fax:925-778-1879
Practice Address - Street 1:2926 LONE TREE WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4924
Practice Address - Country:US
Practice Address - Phone:925-451-4724
Practice Address - Fax:925-778-1879
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist