Healthcare Provider Details

I. General information

NPI: 1538998737
Provider Name (Legal Business Name): CESAR ESQUIVEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 E STUHR RD
NEWMAN CA
95360-2725
US

IV. Provider business mailing address

855 E STUHR RD
NEWMAN CA
95360-2725
US

V. Phone/Fax

Practice location:
  • Phone: 209-556-3177
  • Fax:
Mailing address:
  • Phone: 209-556-3177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: