Healthcare Provider Details

I. General information

NPI: 1346591591
Provider Name (Legal Business Name): CHRISTINE EVANS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE EVANS HODGE M.D.

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR MAILBOX 8809
SAN DIEGO CA
92103-9000
US

IV. Provider business mailing address

970 W VALLEY PKWY # 113
ESCONDIDO CA
92025-2554
US

V. Phone/Fax

Practice location:
  • Phone: 619-233-8500
  • Fax:
Mailing address:
  • Phone: 619-632-2747
  • Fax: 844-907-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA124644
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: