Provider Demographics
NPI:1861084097
Name:EVANS, BRIANNA MARIE (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S PARKER ST STE 2800
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4720
Mailing Address - Country:US
Mailing Address - Phone:424-284-2440
Mailing Address - Fax:415-296-5299
Practice Address - Street 1:701 S PARKER ST STE 2800
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4720
Practice Address - Country:US
Practice Address - Phone:424-284-2440
Practice Address - Fax:415-296-5299
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW995491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty