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General NPI Number Information
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NPI Number | 1760924849
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Entity Type | Individual
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Provider Name | JULIA EVANS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 940 S COAST DR STE 225
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City | COSTA MESA
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State | CA
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Zip | 92626-7757
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Country | US
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Telephone | 949-743-1457
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Fax | 949-274-8299
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Provider Business Mailing Address
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Address Line | 940 S COAST DR STE 225
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City | COSTA MESA
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State | CA
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Zip | 92626-7757
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Country | US
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Telephone | 949-743-1457
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Fax | 949-274-8299
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY28398
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY28398
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License Number State | CA
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