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General NPI Number Information
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NPI Number | 1255255345
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Entity Type | Individual
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Provider Name | KYLIE BREANNE EVANS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 3951 N WALNUT RD
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City | TURLOCK
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State | CA
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Zip | 95382-9539
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Country | US
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Telephone | 350-206-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 2524 LESTER RD
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City | DENAIR
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State | CA
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Zip | 95316-8528
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Country | US
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Telephone | 209-262-8771
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 30356
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License Number State | CA
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