Healthcare Provider Details

I. General information

NPI: 1164141867
Provider Name (Legal Business Name): FRANCES ESCAMILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 RICHLAND AVE BLDG A
CERES CA
95307-4562
US

IV. Provider business mailing address

1904 RICHLAND AVE BLDG A
CERES CA
95307-4562
US

V. Phone/Fax

Practice location:
  • Phone: 209-548-5255
  • Fax:
Mailing address:
  • Phone: 209-548-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: