Individual provider Active NPI

Evan Cedar Keeler-Wolf, AMFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1063393528
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT157860 Issued in CA
Practice address
5480 College Ave Ste 2
Oakland, CA 94618-1552
Phone
(510) 336-4646
NPI assigned
Sep 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X AMFT157860 CA Primary

Addresses

Primary practice location

5480 College Ave Ste 2
Oakland, CA 94618-1552

Mailing address

40 Lane CT
Oakland, CA 94611-3129
Phone (510) 384-1468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT157860CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1063393528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 LANE CT",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946113129",
            "telephone_number": "510-384-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 COLLEGE AVE STE 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946181552",
            "telephone_number": "510-336-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELER-WOLF",
        "first_name": "EVAN",
        "middle_name": "CEDAR",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT157860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.