Healthcare Provider Details

I. General information

NPI: 1477963098
Provider Name (Legal Business Name): ANDREA ESCALANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17695 INDUSTRIAL FARM RD
BAKERSFIELD CA
93308-9520
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-391-7948
  • Fax: 661-391-7978
Mailing address:
  • Phone: 661-868-6601
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number266709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: