Basic Information
| Provider Information | |||||||||
| NPI: | 1194224345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIAMPA | ||||||||
| FirstName: | EVELYN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 VALPREDA RD | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920692973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607366703 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 VALPREDA RD | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920692973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607366767 | ||||||||
| FaxNumber: | 7607368740 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2018 | ||||||||
| LastUpdateDate: | 02/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | NP95008432 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.