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General NPI Number Information
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NPI Number | 1003385873
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Entity Type | Individual
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Provider Name | EVELIN CIFUENTES
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Gender | Female
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 3031 BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90057-1013
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Country | US
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Telephone | 323-644-9380
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Fax |
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Provider Business Mailing Address
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Address Line | 9012 VARNA AVE
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City | ARLETA
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State | CA
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Zip | 91331-6136
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Country | US
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Telephone | 818-416-4118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 6282
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License Number State | CA
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