Healthcare Provider Details

I. General information

NPI: 1295959252
Provider Name (Legal Business Name): EVELYN WARFEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 S STATE ST STE A
SAN JACINTO CA
92583-4922
US

IV. Provider business mailing address

1370 S STATE ST STE A
SAN JACINTO CA
92583-4922
US

V. Phone/Fax

Practice location:
  • Phone: 951-791-3700
  • Fax: 951-791-3300
Mailing address:
  • Phone: 951-358-6919
  • Fax: 951-791-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: