Provider Demographics
NPI:1922268622
Name:OLIVAS, EVELYN (PROBATION OFFICER)
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:PROBATION OFFICER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 IMPERIAL HWY RM P-31
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2835
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:562-658-7425
Practice Address - Street 1:4849 CIVIC CENTER WAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1679
Practice Address - Country:US
Practice Address - Phone:323-780-2125
Practice Address - Fax:323-262-8412
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA171M00000XOtherPROBATION DEPARTMENT