Individual provider Active NPI

Jennifer A Evans, PH.D.

  • Clinical Psychologist
  • Reno, NV
National Provider Identifier
1104060623
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY0578 Issued in NV
Practice address
1000 Locust St
Mental Health Service (116)
Reno, NV 89502-2597
Phone
(888) 838-6256
Fax
(775) 328-1858
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY0578 NV Primary

Addresses

Primary practice location

1000 Locust St
Mental Health Service (116)
Reno, NV 89502-2597

Mailing address

1000 Locust St
Mental Health Service (116)
Reno, NV 89502-2597
Phone (888) 838-6256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY0578NVMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1104060623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LOCUST ST",
            "address_2": "MENTAL HEALTH SERVICE (116)",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022597",
            "telephone_number": "888-838-6256",
            "fax_number": "775-328-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LOCUST ST",
            "address_2": "MENTAL HEALTH SERVICE (116)",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022597",
            "telephone_number": "888-838-6256",
            "fax_number": "775-328-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PSY0578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.