Kevin Michael Eagleson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13635 Issued in CA

Practice address

30 Joseph CT
San Rafael, CA 94903-2664

Phone

(415) 785-4993

Fax

(415) 599-4362

NPI assigned

Sep 7, 2026

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

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

{
    "created_epoch": "1788739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1235048943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MISSION DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525281",
            "telephone_number": "415-408-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JOSEPH CT",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032664",
            "telephone_number": "415-785-4993",
            "fax_number": "415-599-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLESON",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-07",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "13635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Ryan Duva, PSY.D.
• Cameron Duvall
• Cynthia Jaramillo Duxbury, MFT
• Susan Ann Dyer, PSY.D.
• Kathleen Ann Eagle, PSYD
• Eliscia Denise Easiley
• Anthony A. Eason, MD
• Samer Magdi Ebeid, D.D.S.
• Laura Worth Eberhard, MD
• Wendy Eberhardt, MD

• Addiction (Substance Use Disorder) Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.