Healthcare Provider Details

I. General information

NPI: 1437467057
Provider Name (Legal Business Name): CAROLINA ESQUIVIAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2010
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 AVALON BLVD
LOS ANGELES CA
90011-5622
US

IV. Provider business mailing address

18032 ERMANITA AVE
TORRANCE CA
90504-3905
US

V. Phone/Fax

Practice location:
  • Phone: 323-432-5185
  • Fax: 323-432-5086
Mailing address:
  • Phone: 310-977-4740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29721
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: