Healthcare Provider Details

I. General information

NPI: 1720940141
Provider Name (Legal Business Name): NATALIE ESCAMILLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3186 AIRWAY AVE STE A
COSTA MESA CA
92626-4650
US

IV. Provider business mailing address

28820 SANTA ROSA RD
NUEVO CA
92567-9796
US

V. Phone/Fax

Practice location:
  • Phone: 714-881-0427
  • Fax: 714-327-0673
Mailing address:
  • Phone: 951-385-3716
  • Fax: 951-385-3716

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: