| Evergreen Psychotherapy Apc | |
|
1580 W El Camino Real Ste 2 Mountain View CA 94040-2461 | |
| (740) 707-0488 | |
| Not Available |
| Full Name | Evergreen Psychotherapy Apc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1580 W El Camino Real Ste 2, Mountain View, California |
| Authorized Official Name and Position | Akanksha Srivastav (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6692827234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Psychotherapy Apc 1030 E El Camino Real # 362 Sunnyvale CA 94087-3759 Ph: (740) 707-0488 | Evergreen Psychotherapy Apc 1580 W El Camino Real Ste 2 Mountain View CA 94040-2461 Ph: (740) 707-0488 |
| NPI Number | 1174218358 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174218358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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