EVAN LEE HENDRIKS (NPI# 1952825754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952825754 |
| Entity Type | Individual |
| Full Name | EVAN LEE HENDRIKS |
| Credential | PA |
| Practice Address |
301 S Glendora Ave Apt 2142 West Covina CA 91790 |
| Mailing Address |
301 S Glendora Ave Unit 2142 West Covina CA 91790-5918 |
| Practice Telephone | (712) 259-0874 |
| Mailing Telephone | 7122590874 |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
301 S GLENDORA AVE APT 2142 |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285279067 | Liang-wen Chen | Acupuncturist | 1433 West Merced Ave. Suite 304, West Covina, CA 91790 | 2019-11-15 |
| 1245880517 | Cheuk Man Chan | Acupuncturist | 1433 W Merced Ave., #309, West Covina, CA 91790 | 2019-09-18 |
| 1982174561 | Alexandra Isaacs | Marriage & Family Therapist | 1215 W. West Covina Pkwy., West Covina, CA 91790 | 2018-11-27 |
| 1568949709 | Lulua Zulfikarali Bahrainwala | Student in an Organized Health Care Education/Training Program | 1115 S Sunset Avenue #3940, West Covina, CA 91790 | 2018-07-20 |
| 1417442740 | Lydia Joy David | Nurse Practitioner | 1769 S Sunset Ave, West Covina, CA 91790 | 2018-06-28 |
| 1043721046 | Kimberly E Nevarez | Specialist/Technologist | 410 E Merced Ave Suite D, Suite D, West Covina, CA 91790 | 2017-10-17 |
| 1669994588 | Meryl Francine Liu | Dentist | 1101 S. Glendora Ave #a, West Covina, CA 91790 | 2017-07-12 |
| 1326586330 | Athena Merianos | Marriage & Family Therapist | 1215 W. West Parkway, West Covina, CA 91790 | 2017-02-09 |
| 1912445990 | Lissette Bueno | Case Manager/Care Coordinator | 1517 West Garvey Ave North, West Covina, CA 91790 | 2017-02-09 |
| 1063957009 | Jacqueline Johnson | Nurse Practitioner | 420 S. Glendora Ave, West Covina, CA 91790 | 2016-12-29 |
| Find all providers in zip 91790 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578949954 | Jose Trinidad Rodriguez | Physician Assistant | 396 S. California Ave #2161, West Covina, CA 91793-9998 | 2015-08-07 |
| 1699198051 | Maria Suzanne Goldman | Physician Assistant | Emanate Health Queen of The Valley Hospital Medical Sta, 1115 South Sunset Avenue, West Covina, CA 91790 | 2014-01-21 |
| 1821310103 | Rita Farr | Physician Assistant | 1500 W West Covina Pkwy # 150, West Covina, CA 91790 | 2010-02-27 |
| 1407968712 | Thuc N Ly | Physician Assistant | 3433 Fionna Pl, West Covina, CA 91792-5703 | 2006-08-31 |
| 1477505014 | Kimberly Jean Amato | Physician Assistant | 420 S Glendora Ave, West Covina, CA 91790-3001 | 2006-05-16 |
| 1437789195 | Dustin Ken Kwon | Physician Assistant | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2020-01-22 |
| 1114571023 | Eric Edwin Edillon | Physician Assistant | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2019-07-29 |
| 1861050692 | Ellin Li | Physician Assistant | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2019-06-05 |
| 1356816029 | Steven Bidwell | Physician Assistant | 818 W Cameron Ave, West Covina, CA 91790-4136 | 2018-10-09 |
| 1285129049 | Tanya Phan | Physician Assistant | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2018-06-25 |
| Find all providers in WEST COVINA | ||||
| City | WEST COVINA |
| Zip Code | 91790 |
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| 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.