Healthcare Provider Details

I. General information

NPI: 1407747512
Provider Name (Legal Business Name): JOEL ALEJANDRO ESCARENO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W HENDERSON AVE
PORTERVILLE CA
93257-1732
US

IV. Provider business mailing address

333 W HENDERSON AVE
PORTERVILLE CA
93257-1732
US

V. Phone/Fax

Practice location:
  • Phone: 559-361-5546
  • Fax:
Mailing address:
  • Phone: 559-361-5546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: