Healthcare Provider Details

I. General information

NPI: 1881389476
Provider Name (Legal Business Name): KRISTEN ESCALERA L.A.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8358 FLORENCE AVE
DOWNEY CA
90240-3917
US

IV. Provider business mailing address

669 S UNION AVE APT 614
LOS ANGELES CA
90017-1662
US

V. Phone/Fax

Practice location:
  • Phone: 562-622-2222
  • Fax:
Mailing address:
  • Phone: 424-249-0209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: