MR. KEVIN MICHAEL EAGLESON NPI 1235048943

NPI Information

  • NPI: 1235048943
  • Provider Name: MR. KEVIN MICHAEL EAGLESON
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 30 JOSEPH CT
    SAN RAFAEL, CA
    ZIP 94903
  • Phone: (415) 785-4993

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NPI Details

MR. Kevin Michael Eagleson is an addiction (substance use disorder) counselor in San Rafael, CA. MR. Kevin Michael Eagleson NPI is 1235048943. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

30 JOSEPH CT
SAN RAFAEL, CA
ZIP 94903-664
Phone: (415) 785-4993
Fax: (415) 599-4362

The enumeration date for this NPI number is 9/7/2026 and was last updated on 9/7/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)13635CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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