Healthcare Provider Details

I. General information

NPI: 1962293605
Provider Name (Legal Business Name): LOIDA MERELY ESCOBAR AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3685 MOTOR AVE
LOS ANGELES CA
90034-5750
US

IV. Provider business mailing address

716 IMOGEN AVE APT 1
LOS ANGELES CA
90026-3501
US

V. Phone/Fax

Practice location:
  • Phone: 323-301-3954
  • Fax:
Mailing address:
  • Phone: 323-301-3954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC19097
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT154125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: