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:
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Health care specialties

SpecialtyCodeLicense #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 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164570693 NPPES
California MEDICAID 01682104

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