Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-33644 | CA |
N | 106S00000X | Behavior Technician |
NPI | 1003318502 |
---|---|
Provider Name | Elisabeth Kathryn Evans |
First Address | Sacramento, CA 95825-5430 |
Second Address | Sacramento, CA 95826-9716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2018 |
Last Update Date | 12/02/2019 |