Provider Demographics
NPI:1154118180
Name:CAMBA, EVELYN (RN)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:CAMBA
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5065 SEA DRIFT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-8444
Mailing Address - Country:US
Mailing Address - Phone:619-274-2353
Mailing Address - Fax:
Practice Address - Street 1:5065 SEA DRIFT WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-8444
Practice Address - Country:US
Practice Address - Phone:619-274-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA628672163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health