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General NPI Number Information
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NPI Number | 1952456634
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Entity Type | Individual
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Provider Name | JAMES EVANS PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 1315 WINDRIM AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19141-2710
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Country | US
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Telephone | 215-456-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 6748 PECHIN ST FIRST FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19128-4537
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Country | US
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Telephone | 215-508-3636
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS-008671-L
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License Number State | PA
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