Healthcare Provider Details

I. General information

NPI: 1649971524
Provider Name (Legal Business Name): HOLLY ANN-MARIE ESCALERA AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 E. HUNTINGTON DR.
DUARTE CA
91010-2221
US

IV. Provider business mailing address

1334 W FOOTHILL BLVD APT 2F
UPLAND CA
91786-3655
US

V. Phone/Fax

Practice location:
  • Phone: 626-263-9133
  • Fax:
Mailing address:
  • Phone: 626-665-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: