Healthcare Provider Details

I. General information

NPI: 1700906849
Provider Name (Legal Business Name): SONIA LOURDES ESCAMILLA ASW 12458
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 150
OXNARD CA
93036-2612
US

IV. Provider business mailing address

3487 BARCA ST
CAMARILLO CA
93010-3907
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-8460
  • Fax: 805-981-8461
Mailing address:
  • Phone: 805-484-5494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: