Provider Demographics
NPI:1881721355
Name:HOVIVIAN, ERNEST GREGORY JR (MFT)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:GREGORY
Last Name:HOVIVIAN
Suffix:JR
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 1:13800 HEACOCK ST
Mailing Address - Street 2:SUITE #C236
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-3339
Mailing Address - Country:US
Mailing Address - Phone:951-653-0819
Mailing Address - Fax:
Practice Address - Street 1:13800 HEACOCK ST
Practice Address - Street 2:SUITE #C236
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-3339
Practice Address - Country:US
Practice Address - Phone:951-653-0819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41825106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist