Healthcare Provider Details

I. General information

NPI: 1306398755
Provider Name (Legal Business Name): SARAH ELIZABETH ESCALANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 MOUNT LANGLEY ST SUITE 220
FOUNTAIN VALLEY CA
92708-6900
US

IV. Provider business mailing address

18350 MOUNT LANGLEY ST SUITE 220
FOUNTAIN VALLEY CA
92708-6900
US

V. Phone/Fax

Practice location:
  • Phone: 714-378-2620
  • Fax: 714-378-2631
Mailing address:
  • Phone: 714-378-2620
  • Fax: 714-378-2631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: