Individual
EVELYN DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S RANCHO DR STE A10, LAS VEGAS, NV 89106-4898
(702) 437-4673
Mailing address
601 S RANCHO DR STE A10, LAS VEGAS, NV 89106-4898
(702) 437-4673
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CI5054
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-1661683
MEDI-CAL
CA
Enumeration date
08/19/2019
Last updated
12/03/2021
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