# COMMUNITY EVOLUTION ACQUISITION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710849468
- **Authorized official:** TIA LOPEZ BACHELORS SOCIAL W (CEO)
- **Authorized official phone:** (424) 210-2933

## Contact information

- **Practice address:** 1767 VALLECITO DR, SAN PEDRO, CA 90732-4245
- **Practice address phone:** (424) 503-3336
- **Mailing address:** 1767 VALLECITO DR, SAN PEDRO, CA 90732-4245
- **Mailing address phone:** (424) 210-2933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | — | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 12/02/2025
- **Last updated:** 09/19/2026