Provider Demographics
NPI:1033645312
Name:SCHWABE, EVELYN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:
Last Name:SCHWABE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1655 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5801
Mailing Address - Country:US
Mailing Address - Phone:323-737-5200
Mailing Address - Fax:323-737-5400
Practice Address - Street 1:1655 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5801
Practice Address - Country:US
Practice Address - Phone:323-737-5200
Practice Address - Fax:323-737-5400
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006362363L00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily