Healthcare Provider Details

I. General information

NPI: 1891588620
Provider Name (Legal Business Name): ERICA LYNN ESCOBEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2025
Last Update Date: 05/24/2025
Certification Date: 05/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11445 E VIA LINDA STE 235
SCOTTSDALE AZ
85259-2655
US

IV. Provider business mailing address

13602 N 44TH ST APT 298
PHOENIX AZ
85032-6375
US

V. Phone/Fax

Practice location:
  • Phone: 602-403-5220
  • Fax:
Mailing address:
  • Phone: 602-402-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA16213
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: