Healthcare Provider Details

I. General information

NPI: 1356403596
Provider Name (Legal Business Name): MELISSA EVANS VALLAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ANTIONETTE EVANS

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N OCCIDENTAL BLVD
LOS ANGELES CA
90026-4641
US

IV. Provider business mailing address

27772 REEL LN
VALENCIA CA
91381-2108
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-2931
  • Fax:
Mailing address:
  • Phone: 650-796-7385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA96788
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: