Healthcare Provider Details

I. General information

NPI: 1508748476
Provider Name (Legal Business Name): ADRIANA ESCOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23701 BIRTCHER DR
LAKE FOREST CA
92630-1772
US

IV. Provider business mailing address

23701 BIRTCHER DR
LAKE FOREST CA
92630-1772
US

V. Phone/Fax

Practice location:
  • Phone: 855-581-0100
  • Fax:
Mailing address:
  • Phone: 855-581-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: