Provider Demographics
NPI:1679621866
Name:BYRAM, EVELYN (L AC)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:BYRAM
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 CALLE SANTA CRUZ
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-6610
Mailing Address - Country:US
Mailing Address - Phone:760-632-5168
Mailing Address - Fax:760-632-5168
Practice Address - Street 1:2146 ENCINITAS BLVD
Practice Address - Street 2:SUITE 105-106
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4371
Practice Address - Country:US
Practice Address - Phone:760-944-3987
Practice Address - Fax:760-944-6999
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist