Individual
JADYN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
24400 JACKSON AVE STE. A, MURRIETA, CA 92562-1987
(951) 677-5144
Mailing address
24640 JEFFERSON AVE, STE 100, MURRIETA, CA 92562-9030
(619) 804-6374
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14016
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GE3092
MEDICARE PTAN
CA
Enumeration date
07/16/2010
Last updated
03/14/2017
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