Individual
DR. GWENDOLYN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
176 PALO ALTO AVE, SAN FRANCISCO, CA 94114-2122
(415) 681-1922
Mailing address
176 PALO ALTO AVE, SAN FRANCISCO, CA 94114-2122
(415) 681-1922
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY14089
CA
103T00000X
Psychologist
PSY14089
CA
103TC0700X
Clinical Psychologist
Primary
PSY14089
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01682104
—
CA
Enumeration date
01/08/2007
Last updated
09/20/2007
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