Healthcare Provider Details

I. General information

NPI: 1730203456
Provider Name (Legal Business Name): PAMELA ANN ESQUIVEL N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST SUITE A220
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

11234 ANDERSON ST SUITE A220
LOMA LINDA CA
92354-2804
US

V. Phone/Fax

Practice location:
  • Phone: 909-651-5449
  • Fax: 909-558-0550
Mailing address:
  • Phone: 909-651-5449
  • Fax: 909-558-0550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number416220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: