Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 37129 | CA |
NPI | 1538585708 |
---|---|
Provider Name | Elizabeth Evans |
First Address | Mountain View, CA 94043-3945 |
Second Address | Cupertino, CA 95014-2356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2014 |
Last Update Date | 12/03/2014 |