Healthcare Provider Details

I. General information

NPI: 1518166156
Provider Name (Legal Business Name): TERRIE LYNN EVENS REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 SANTA RITA ROAD BEHAVIORAL HEALTH QUEST #10
PLEASTON CA
94566-6329
US

IV. Provider business mailing address

566 CENTO COURT MRS TERRIE LYNN EVENS RN
PLEASANTON CA
94566-6329
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-6441
  • Fax: 925-426-6851
Mailing address:
  • Phone: 925-426-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number543681
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: