Individual
MARILYN VIVICA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1250 16TH ST, SANTA MONICA, CA 90404-1249
(424) 259-9440
Mailing address
2415 MOHAWK ST, PASADENA, CA 91107-4202
(323) 346-7107
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95114161
CA
Other
Enumeration date
05/20/2021
Last updated
05/26/2021
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