# LIFEMARK MARRIAGE & FAMILY THERAPY CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifemark Behavioral Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619690401
- **Authorized official:** DR. JOHN MICHAEL EVOSEVICH PHD, LMFT (OWNER/CEO)
- **Authorized official phone:** (760) 413-1951

## Contact information

- **Practice address:** 3819 1ST AVE UNIT 208, SAN DIEGO, CA 92103-3082
- **Practice address phone:** (760) 413-1951
- **Mailing address:** 3819 1ST AVE UNIT 208, SAN DIEGO, CA 92103-3082
- **Mailing address phone:** (760) 413-1951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2022
- **Last updated:** 09/26/2022