Healthcare Provider Details

I. General information

NPI: 1982374328
Provider Name (Legal Business Name): EVA POWLESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14181 TELEGRAPH RD
WHITTIER CA
90604-2554
US

IV. Provider business mailing address

14181 TELEGRAPH RD
WHITTIER CA
90604-2554
US

V. Phone/Fax

Practice location:
  • Phone: 562-273-0722
  • Fax:
Mailing address:
  • Phone: 562-273-0722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW105284
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: