Doctor Name: | NAMIKO EVANS |
NPI Number: | 1114209376 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 28097 |
Business Practice Address: | 427 Encinal Canyon Rd Malibu, CA - 902652404 |
Business Phone Number: | 8188891353 |
Business Fax Number: | |
Mailing Address: | Po Box 8645, LA VERNE |
State: | CA |
Postal Code: | 917508645 |
Phone Number: | 9099733933 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2011 |
NPI Last Update Date: | 09/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 28097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |