Evolved, Inc.
Clinic/Center (Multi-Specialty)

Address: 10573 W Pico Blvd Unit 414, Los Angeles, CA 90064-2333
Phone: 3109270654

Evolved, Inc. (NPI# 1699245654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1699245654
Entity Type Organization
Organization Name EVOLVED, INC.
Practice Address 10573 W Pico Blvd Unit 414
Los Angeles
CA 90064-2333
Practice Telephone 3109270654
Mailing Address 10573 W Pico Blvd Unit 414
Los Angeles
CA 90064-2333
Mailing Telephone 3109270654
Authorized Official Name Diana Velasco (CEO)
Authorized Official Telephone 3109270654
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2018-12-03
Last Update Date 2018-12-03

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 261QM1300X Clinic/Center · Multi-Specialty Ambulatory Health Care Facilities

Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Office Location

Street Address 10573 W PICO BLVD UNIT 414
State CA
Zip Code 90064-2333

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134727597 Barbara K. Polland Marriage & Family Therapist 10533 Rountree Rd., Los Angeles, CA 90064 2020-10-16
1912542994 Reproductive Medicine Associates of Socal Ambulatory Surgery Center Clinic/Center 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 2019-11-13
1376022012 Payersdirect, Inc. Radiology 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 2018-08-13
1013404136 Jeannie Wakamatsu Dietitian, Registered 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 2018-04-13
1487153474 Victor Louie Behavior Technician 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 2018-02-06
1407386089 Ovsanna Stepanyan Rehabilitation Practitioner 11080 W Olimpic Blvd, La, CA 90064 2017-06-15
1952768012 Grace Gayles Behavior Analyst 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 2016-01-20
1669841003 Jessica Hildebrandt Occupational Therapy Assistant 2446 S Westgate Ave, Los Angeles, CA 90064 2015-09-16
1033592571 Joshua Busse Family Medicine 11845 Olympic Boulevard, Los Angeles, CA 90064 2015-07-01
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Zip Code 90064

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.