Healthcare Provider Details

I. General information

NPI: 1215609904
Provider Name (Legal Business Name): ERIKA ESCANDON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15406 W SELLS DR
GOODYEAR AZ
85395-6392
US

IV. Provider business mailing address

6404 S 71ST DR
LAVEEN AZ
85339-5015
US

V. Phone/Fax

Practice location:
  • Phone: 928-221-7289
  • Fax:
Mailing address:
  • Phone: 928-779-1679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA12611
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: