Healthcare Provider Details

I. General information

NPI: 1871455253
Provider Name (Legal Business Name): DIANA ISABEL ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77711 FLORA RD STE 327
PALM DESERT CA
92211-4103
US

IV. Provider business mailing address

14205 CANTERBURY DR
VICTORVILLE CA
92395-4313
US

V. Phone/Fax

Practice location:
  • Phone: 909-726-4030
  • Fax:
Mailing address:
  • Phone: 760-220-4377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: