Provider Demographics
NPI:1407463847
Name:EVANO, TWYLA (PT, DPT, NCS, ATP)
Entity Type:Individual
Prefix:DR
First Name:TWYLA
Middle Name:
Last Name:EVANO
Suffix:
Gender:F
Credentials:PT, DPT, NCS, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 E PROMENADE UNIT E
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-6801
Mailing Address - Country:US
Mailing Address - Phone:805-236-0953
Mailing Address - Fax:
Practice Address - Street 1:5350 OLIVE ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-1639
Practice Address - Country:US
Practice Address - Phone:909-497-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA431062251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43106OtherPHYSICAL THERAPY BOARD OF CALIFORNIA