Healthcare Provider Details

I. General information

NPI: 1851193221
Provider Name (Legal Business Name): FRANCISCO ALEJANDRO ESCOBAR, LOPEZ RADT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83844 HOPI AVE
INDIO CA
92203-2638
US

IV. Provider business mailing address

83844 HOPI AVE
INDIO CA
92203-2638
US

V. Phone/Fax

Practice location:
  • Phone: 760-347-9442
  • Fax: 760-342-8022
Mailing address:
  • Phone: 760-347-9442
  • Fax: 760-342-8022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR1556530424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: