Provider Demographics
NPI:1952094849
Name:SPECTOR, EVELYN YEE (RN)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:YEE
Last Name:SPECTOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:EVELYN
Other - Middle Name:YEA
Other - Last Name:FOXFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:625 SHAMROCK LN
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93449-3294
Mailing Address - Country:US
Mailing Address - Phone:805-458-3105
Mailing Address - Fax:
Practice Address - Street 1:117 W TUNNELL ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4096
Practice Address - Country:US
Practice Address - Phone:805-614-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA644095163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health