Healthcare Provider Details

I. General information

NPI: 1669756847
Provider Name (Legal Business Name): NANCY LOUISE EVANS N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23456 HAWTHORNE BLVD
TORRANCE CA
90505-4716
US

IV. Provider business mailing address

1065 E HILLSDALE BLVD HOLTORF MEDICAL GROUP #108
FOSTER CITY CA
94404-1613
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-2705
  • Fax: 310-375-2701
Mailing address:
  • Phone: 650-638-1141
  • Fax: 650-638-1144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: