Healthcare Provider Details

I. General information

NPI: 1669299228
Provider Name (Legal Business Name): RAMONA ESCARENO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11748 MAGNOLIA AVE
RIVERSIDE CA
92503-7123
US

IV. Provider business mailing address

58562 CAMPANULA ST
YUCCA VALLEY CA
92284-1230
US

V. Phone/Fax

Practice location:
  • Phone: 951-440-6220
  • Fax:
Mailing address:
  • Phone: 760-217-8868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: