Evolibri Consulting

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

EVOLIBRI CONSULTING

Practice address

4655 Old Ironsides Dr Ste 170
Santa Clara, CA 95054-1853

Phone

(408) 735-7990

NPI assigned

Jul 16, 2019

Organization subpart

No

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

Authorized official

Name

Jan Johnston Tyler

Title

Owner

Phone

(650) 245-1855

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Nicole Kufer, MSOT OTR/L

  • Occupational Therapist
  • Willows, CA
  • NPI 1235632118
  NPD (past)
• Charlene Mahabali

  • Mental Health Counselor
  • San Mateo, CA
  • NPI 1316203904

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1396398640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 OLD IRONSIDES DR STE 170",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541853",
            "telephone_number": "408-735-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 OLD IRONSIDES DR STE 170",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541853",
            "telephone_number": "408-735-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLIBRI CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "JOHNSTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-245-1855"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kyle Fahey
• Erica Renee Fahmy, MA, OTR/L, PAM, SWC

• Marriage & Family Therapist in Santa Clara, CA
• Providers in Santa Clara, 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 Jul 16, 2019; 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.