Provider Demographics
NPI:1801416839
Name:EVANS, EVELYN LOUISE (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:LOUISE
Last Name:EVANS
Suffix:
Gender:F
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1722 STATE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2526
Mailing Address - Country:US
Mailing Address - Phone:805-884-4900
Mailing Address - Fax:805-456-8118
Practice Address - Street 1:1722 STATE ST STE 103
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2526
Practice Address - Country:US
Practice Address - Phone:805-884-4900
Practice Address - Fax:805-456-8118
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA61034531363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant