Evolve Psychiatry, PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

EVOLVE PSYCHIATRY, PC

Practice address

300 N Pacific Coast Hwy Ste 2060
El Segundo, CA 90245-4479

Phone

(404) 386-6373

NPI assigned

Jun 16, 2020

Last updated

Jun 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth F Wood

Title

Assistant Secretary

Phone

(424) 290-3341

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1588289417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N PACIFIC COAST HWY STE 2060",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N PACIFIC COAST HWY STE 2060",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454479",
            "telephone_number": "404-386-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PSYCHIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "424-290-3341"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay Freeman Evans
• Diamond Prado Evans
• Ronald Evans
• Evolve Growth Initiatives LLC
• Evolve Growth Initiatives, LLC
• Tavian Ewan
• Eyes on PCH Optometry a Professional Corporation
• Ella Ezelle
• Alec Ezrre Castrejon
• Ulisses Fabela

• Psychiatry Physician in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.