Individual
RETAURA MONA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 S VERMONT AVE, LOS ANGELES, CA 90037-3527
(323) 751-3026
Mailing address
5201 S VERMONT AVE, LOS ANGELES, CA 90037-3527
(323) 751-3026
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41000
CA
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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