Provider Demographics
NPI:1649460684
Name:EVANS, BOZHENA (LCSW)
Entity type:Individual
Prefix:
First Name:BOZHENA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BOZHENA
Other - Middle Name:
Other - Last Name:NEBRAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 BREAKERS BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-7400
Mailing Address - Country:US
Mailing Address - Phone:913-645-5179
Mailing Address - Fax:
Practice Address - Street 1:1505 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2106
Practice Address - Country:US
Practice Address - Phone:510-972-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical