Andre Evans, AMFT-122136

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122136 Issued in CA

Practice address

456 Old Newport Blvd
Newport Beach, CA 92663-4211

Phone

(949) 781-9025

NPI assigned

Mar 3, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrea M Wagner Psychologist PC

  dba Redeemed Mental Health

  • Adult Mental Health Clinic/Center
  • Newport Beach, CA
  • NPI 1770314270
  NPD
• Redeemed Mental Health LLC

  dba Redeemed Mental Health

  • Adult Mental Health Clinic/Center
  • Newport Beach, CA
  • NPI 1952084451
  NPD

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1083412456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 OLD NEWPORT BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634211",
            "telephone_number": "949-781-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 OLD NEWPORT BLVD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634211",
            "telephone_number": "949-781-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANDRE",
        "credential": "AMFT-122136",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Etemad-Haary, LMFT
• Abrak Etemad, DMD
• Leila Ettefagh, M.D.
• Eugene K Kim MD Inc
• Evangeline Chu MD a Medical Corporation
• April R Evans, M.D.
• Corwin Winslow Evans, D.D.S.
• Jeff Evans
• Emily Elane Evavold
• Evolve Within Child & Adult Therapy, Inc.

• Marriage & Family Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.