Provider Demographics
NPI:1861902280
Name:JULIA EVANS PHD PSYCHOLOGY PC
Entity type:Organization
Organization Name:JULIA EVANS PHD PSYCHOLOGY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-981-4566
Mailing Address - Street 1:940 S COAST DR STE 225
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7757
Mailing Address - Country:US
Mailing Address - Phone:949-743-1457
Mailing Address - Fax:
Practice Address - Street 1:940 S COAST DR STE 225
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7757
Practice Address - Country:US
Practice Address - Phone:949-743-1457
Practice Address - Fax:974-274-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY28398OtherBOARD OF PSYCHOLOGY