Healthcare Provider Details

I. General information

NPI: 1467084756
Provider Name (Legal Business Name): ESPERANZA ESCOBEDO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 PEAR TREE LN STE 100
NAPA CA
94558-6485
US

IV. Provider business mailing address

1141 PEAR TREE LN STE 100
NAPA CA
94558-6485
US

V. Phone/Fax

Practice location:
  • Phone: 707-254-1770
  • Fax: 707-254-1779
Mailing address:
  • Phone: 707-254-1770
  • Fax: 707-254-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95166062
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: