Healthcare Provider Details

I. General information

NPI: 1922925577
Provider Name (Legal Business Name): CARRI LEE ESCALANTE NURSE ASSIATANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44725 HOLTVILLE AVE
JACUMBA CA
91934-2139
US

IV. Provider business mailing address

PO BOX 313049
GUATAY CA
91931-3049
US

V. Phone/Fax

Practice location:
  • Phone: 619-609-6379
  • Fax:
Mailing address:
  • Phone: 619-609-6379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number00940527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: