Provider Demographics
NPI:1043713092
Name:TUNCO, EVELYN (ADMINISTRATOR, CNA)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:TUNCO
Suffix:
Gender:F
Credentials:ADMINISTRATOR, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 PINNACLE CT
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-5480
Mailing Address - Country:US
Mailing Address - Phone:760-536-9238
Mailing Address - Fax:
Practice Address - Street 1:1777 PINNACLE CT
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-5480
Practice Address - Country:US
Practice Address - Phone:760-536-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374602662310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility