Healthcare Provider Details

I. General information

NPI: 1639010408
Provider Name (Legal Business Name): RICARDO JARED ESCOBAR RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37745 LASKER AVE
PALMDALE CA
93550-6935
US

IV. Provider business mailing address

37745 LASKER AVE
PALMDALE CA
93550-6935
US

V. Phone/Fax

Practice location:
  • Phone: 661-341-5581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95434131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: