Michelle Evans, PSYD, BCBA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY34964 Issued in CA

Practice address

5005 Canyon Crest Dr
Riverside, CA 92507-7721

Phone

(747) 208-5510

NPI assigned

Apr 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shoreline ABA

  • Behavior Analyst
  • Port Hueneme, CA
  • NPI 1003369687
  NPD (past) Authorized official
• Leili Zarbakhsh Integrated Individual and Family Therapy Prof. Corp.

  • Psychologist
  • Riverside, CA
  • NPI 1235615543

  Clinical

  NPD (past)
• San Diego Brainworks Psychology & Neuropsychology Services

  • Psychologist
  • San Diego, CA
  • NPI 1427458710
  NPD (past)

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1831489533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 BLUE DOLPHIN DR",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930413537",
            "telephone_number": "805-341-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 CANYON CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077721",
            "telephone_number": "747-208-5510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3777 Blue Dolphin Dr.",
            "address_purpose": "LOCATION",
            "city": "Port Hueneme",
            "state": "CA",
            "postal_code": "93041",
            "country_code": "US",
            "telephone_number": "805-341-9214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "0-09-3564",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Evans
• Cheryl Anne Evans, BA, MSC
• Debra Joan Evans, LMFT
• Jennifer Evans
• Kimberley Dawn Evans, HYGIENIST
• Nathan James Evans, NONE
• Nyla Evans
• Roger Evans, CADC II, ICADC
• Evergreen Spine and Pain Centers
• Kathlene Marie Everhart, P.A.

• Clinical Psychologist in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2024; 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.