Healthcare Provider Details

I. General information

NPI: 1508352774
Provider Name (Legal Business Name): ERIKA ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4556 GRANADA AVE
RIVERSIDE CA
92504-2227
US

IV. Provider business mailing address

4556 GRANADA AVE
RIVERSIDE CA
92504-2227
US

V. Phone/Fax

Practice location:
  • Phone: 951-241-4601
  • Fax:
Mailing address:
  • Phone: 951-241-4601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number115435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: