Healthcare Provider Details

I. General information

NPI: 1770461246
Provider Name (Legal Business Name): CHRISTINE DAVIS ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2025
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8765 W KELTON LN
PEORIA AZ
85382-3584
US

IV. Provider business mailing address

22933 N LAS POSITAS DR
SUN CITY WEST AZ
85375-6861
US

V. Phone/Fax

Practice location:
  • Phone: 623-252-0311
  • Fax:
Mailing address:
  • Phone: 808-778-1141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLMSW-22576
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: