Healthcare Provider Details

I. General information

NPI: 1730825514
Provider Name (Legal Business Name): EVOLVE MIND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N PENNSYLVANIA ST STE 201
DENVER CO
80203-1303
US

IV. Provider business mailing address

1600 N PENNSYLVANIA ST STE 201
DENVER CO
80203-1303
US

V. Phone/Fax

Practice location:
  • Phone: 415-991-3831
  • Fax:
Mailing address:
  • Phone: 415-991-3831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GERMAN F ASCANI
Title or Position: DIRECTOR, CMO, CEO
Credential: MD
Phone: 415-991-3831