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General NPI Number Information
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NPI Number | 1013631308
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Entity Type | Individual
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Provider Name | EVELYN ULLOA
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 4101 EASTON DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1021
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Country | US
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Telephone | 661-633-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 EASTON DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1021
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Country | US
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Telephone | 661-633-1700
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Fax | 661-633-1785
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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