Healthcare Provider Details

I. General information

NPI: 1639195266
Provider Name (Legal Business Name): PAMELA J. ESAU PSY.D.,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23461 SOUTH POINTE DRIVE SUITE 375
LAGUNA HILLS CA
92653
US

IV. Provider business mailing address

23461 SOUTH POINTE DRIVE SUITE 375
LAGUNA HILLS CA
92653
US

V. Phone/Fax

Practice location:
  • Phone: 949-509-8271
  • Fax: 949-581-9559
Mailing address:
  • Phone: 949-509-8271
  • Fax: 949-581-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 17327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: