Provider Demographics
NPI:1871728089
Name:AVALON, ZOE A (MA LMFT)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:A
Last Name:AVALON
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LARKIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2610
Mailing Address - Country:US
Mailing Address - Phone:831-854-7138
Mailing Address - Fax:
Practice Address - Street 1:530 LARKIN ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2610
Practice Address - Country:US
Practice Address - Phone:831-854-7138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105628106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA105628OtherBOARD OF BEHAVIORAL SCIENCES