Evans, Gwendolyn
Evans, Gwendolyn is an sole proprietor health care provider with primary practice located at 176 Palo Alto Ave , San Francisco CA 94114-2122. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Evans, Gwendolyn can be contacted via phone (415) 681-1922.Contact Information
Primary practice address
176 Palo Alto Ave
San Francisco CA 94114-2122
Phone: (415) 681-1922
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY14089 | California |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY14089 | California |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY14089 | California |
Profile Details
NPI number | 1164570693 |
---|---|
LBN Legal business name | Evans, Gwendolyn |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 8th, 2007 |
Last updated | Sep 20th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164570693 | NPPES |
California | MEDICAID | 01682104 |
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