Provider Demographics
NPI:1669179222
Name:EVANS, ISAAC DON (PSYD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:DON
Last Name:EVANS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4748 W RUSSELL CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-5164
Mailing Address - Country:US
Mailing Address - Phone:559-972-6793
Mailing Address - Fax:
Practice Address - Street 1:4748 W RUSSELL CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5164
Practice Address - Country:US
Practice Address - Phone:559-972-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty