Healthcare Provider Details

I. General information

NPI: 1043979198
Provider Name (Legal Business Name): JEFFREY ESGUERRA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8727 VAN NUYS BLVD STE 101
PANORAMA CITY CA
91402-2463
US

IV. Provider business mailing address

13652 CANTARA ST
PANORAMA CITY CA
91402-5423
US

V. Phone/Fax

Practice location:
  • Phone: 818-405-0090
  • Fax: 818-899-5969
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number95019099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: