Healthcare Provider Details

I. General information

NPI: 1568137966
Provider Name (Legal Business Name): JESSICA NICOLE ESCOBAR M.S. BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 02/25/2023
Certification Date: 02/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE BLDG A-5, STE 5100
ALHAMBRA CA
91803
US

IV. Provider business mailing address

401 S ALMANSOR ST APT G
ALHAMBRA CA
91801-4292
US

V. Phone/Fax

Practice location:
  • Phone: 626-407-0740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: