EVANS LANE WELLNESS AND RECOVERY CENTER (NPI# 1952635856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952635856 |
| Entity Type | Organization |
| Organization Name | EVANS LANE WELLNESS AND RECOVERY CENTER |
| Practice Address |
2090 Evans Ln San Jose CA 95125-2072 |
| Practice Telephone | 4087932406 |
| Mailing Telephone | 4087932406 |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |
| Authorized Official Name | MRS. SHERRY JOHNSON (LICENSED CLINICAL SUPERVISOR) |
| Authorized Official Telephone | 4087932424 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
2090 EVANS LN |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95125-2072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609941947 | Juan Alberto Sanchez | Social Worker | 2090 Evans Ln, San Jose, CA 95125-2072 | 2006-11-21 |
| 1619576972 | Esmeralda Bautista | Counselor | 2090 Evans Ln, San Jose, CA 95125-2072 | 2020-10-19 |
| 1891345716 | Semir Rocevic | Rehabilitation Counselor | 2090 Evans Ln, San Jose, CA 95125-2072 | 2019-09-12 |
| 1083127583 | Matthew Alexander Kuzmich | Social Worker | 2090 Evans Ln, San Jose, CA 95125-2072 | 2017-11-07 |
| 1083144885 | Alissa Marie Fisher | Case Manager/Care Coordinator | 2090 Evans Ln, San Jose, CA 95125-2072 | 2017-06-14 |
| 1336596881 | Rick Armand Navarro | Social Worker | 2090 Evans Ln, San Jose, CA 95125-2072 | 2016-05-14 |
| 1396105623 | Angela Michelle Galli | Technician, Other | 2090 Evans Ln, San Jose, CA 95125-2072 | 2016-02-29 |
| 1568842250 | Tamera Puthuff | Counselor | 2090 Evans Ln, San Jose, CA 95125-2072 | 2015-06-08 |
| 1477954006 | Maelise Blosse | Marriage & Family Therapist | 2090 Evans Ln, San Jose, CA 95125-2072 | 2014-09-15 |
| 1548678345 | Amanda Cortez | Marriage & Family Therapist | 2090 Evans Ln, San Jose, CA 95125-2072 | 2014-07-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1376197848 | Mariam Samir Abadir | Dentist | 1670 Westwood Dr. Suite K, San Jose, CA 95125 | 2019-08-01 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1659809259 | Edward Escoto | Assistant Behavior Analyst | 2075 Lincoln Ave Ste D, San Jose, CA 95125 | 2017-05-25 |
| 1104288422 | Kristin Ann Dessau | Counselor | 1261 Lincoln Avenue, Suite 202, San Jose, CA 95125 | 2016-03-25 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1598042905 | Walgreens | Exclusive Provider Organization | 2585 Almaden Road, San Jose, CA 95125 | 2011-11-14 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1699093724 | Lokahi Acupuncture, Inc. | Acupuncturist | 1688 Willow Street, Suite B, San Jose, CA 95125 | 2010-05-13 |
| 1538482468 | Mark Lucius Yoslow | Psychologist | 970 Minnesota Avenue, San Jose, CA 95125 | 2010-03-06 |
| Find all providers in zip 95125 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477768588 | Ali Baba Corporation | Community Based Residential Treatment Facility, Mental Illness | 260 S 11th St, San Jose, CA 95112-2134 | 2007-05-11 |
| 1811024789 | Starlight Adolescent | Community Based Residential Treatment Facility, Mental Illness | 5858 Paddon Cir, San Jose, CA 95123-3522 | 2007-02-27 |
| 1922581297 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 1991 Park Ave, San Jose, CA 95126-1423 | 2018-09-12 |
| 1962855411 | Lifemoves - Julian Street Inn | Community Based Residential Treatment Facility, Mental Illness | 546 W Julian St, San Jose, CA 95110-2351 | 2016-07-20 |
| 1669774584 | Momentum | Community Based Residential Treatment Facility, Mental Illness | 2001 The Alameda, San Jose, CA 95126-1136 | 2010-11-29 |
| 1669605267 | Tami Thomason | Community Based Residential Treatment Facility, Mental Illness | 2001 The Alameda, San Jose, CA 95126-1136 | 2009-08-29 |
| 1174784169 | County of Santa Clara | Community Based Residential Treatment Facility, Mental Illness | 2090 Evans Ln, San Jose, CA 95125-2072 | 2008-06-23 |
| 1386852366 | Ali Baba Corporation | Community Based Residential Treatment Facility, Mental Illness | 101 Jose Figueres Ave, San Jose, CA 95116-2022 | 2007-05-21 |
| 1730394834 | Oasis Care, Inc. | Community Based Residential Treatment Facility, Mental Illness | 101 Jose Figueres Ave, San Jose, CA 95116 | 2007-05-11 |
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| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
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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.