MEDICARE: EVA TURNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY20551	CA

General Provider Information

NPI Number	:	1386711646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA TURNER

Provider Business Mailing Address
First Line	:	855 N ORANGE GROVE BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-3333
Country	:	US
Telephone Number	:	626-808-6087
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 N ORANGE GROVE BLVD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91103-3333
Country	:	US
Telephone Number	:	626-796-3453
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	05/16/2013

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