Provider Demographics
NPI:1508690223
Name:ZAYAS, EVANNA
Entity type:Individual
Prefix:
First Name:EVANNA
Middle Name:
Last Name:ZAYAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 W DOUGLAS AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7814
Mailing Address - Country:US
Mailing Address - Phone:951-390-0374
Mailing Address - Fax:
Practice Address - Street 1:106 POLLASKY AVE STE D
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1159
Practice Address - Country:US
Practice Address - Phone:559-203-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health