# JEFFREY LEE EBBAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316471196
- **Authorized official:** JEFF EBBAGE (SOLE PROPRIETOR)
- **Authorized official phone:** (831) 239-1644

## Contact information

- **Practice address:** 6060 GRAHAM HILL RD STE J, FELTON, CA 95018-9764
- **Practice address phone:** (831) 239-1644
- **Mailing address:** 275 VICK DR, SANTA CRUZ, CA 95060-9600
- **Mailing address phone:** (831) 239-1644

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 91247 | CA | Yes |

## Other

- **Enumeration date:** 04/18/2017
- **Last updated:** 04/18/2017