Provider Demographics
NPI:1811355712
Name:ANASTASI, EVANGELIA VASILIOS
Entity type:Individual
Prefix:
First Name:EVANGELIA
Middle Name:VASILIOS
Last Name:ANASTASI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22537 MARLIN PL
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2624
Mailing Address - Country:US
Mailing Address - Phone:818-594-7294
Mailing Address - Fax:818-591-6720
Practice Address - Street 1:22537 MARLIN PL
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2624
Practice Address - Country:US
Practice Address - Phone:818-594-7294
Practice Address - Fax:818-591-6720
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197606220311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home