Healthcare Provider Details

I. General information

NPI: 1801531918
Provider Name (Legal Business Name): MAGDALENA ESCOBEDO C-SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 05/03/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 KATELLA AVE STE C
LOS ALAMITOS CA
90720-3102
US

IV. Provider business mailing address

500 MAINE AVE APT 8
LONG BEACH CA
90802-1137
US

V. Phone/Fax

Practice location:
  • Phone: 562-270-2970
  • Fax: 562-685-0621
Mailing address:
  • Phone: 714-610-3285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: