Healthcare Provider Details

I. General information

NPI: 1366570970
Provider Name (Legal Business Name): JENNIFER CHRIS ESCALERA LCSW, CH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 04/02/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH MADISON AVE STE 300
PASADENA CA
91101
US

IV. Provider business mailing address

254 N LAKE AVE # 275
PASADENA CA
91101-1829
US

V. Phone/Fax

Practice location:
  • Phone: 323-251-3596
  • Fax:
Mailing address:
  • Phone: 323-251-3596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS24559
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: