| Evolve Mind Wellness, Inc | |
|
1020 Gravenstein Hwy S Ste 120 Sebastopol CA 95472-4863 | |
| (415) 991-3831 | |
| Not Available |
| Full Name | Evolve Mind Wellness, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1020 Gravenstein Hwy S Ste 120, Sebastopol, California |
| Authorized Official Name and Position | German F Ascani (CEO, CFO, SECRETARY) |
| Authorized Official Contact | 4159913831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Mind Wellness, Inc 1020 Gravenstein Hwy S Ste 120 Sebastopol CA 95472-4863 Ph: (415) 991-3831 | Evolve Mind Wellness, Inc 1020 Gravenstein Hwy S Ste 120 Sebastopol CA 95472-4863 Ph: (415) 991-3831 |
| NPI Number | 1730825514 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Certification Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730825514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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