Healthcare Provider Details

I. General information

NPI: 1952310898
Provider Name (Legal Business Name): EDNA R. ESQUER FNP,PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 BROADWAY
SACRAMENTO CA
95820-1527
US

IV. Provider business mailing address

4600 BROADWAY
SACRAMENTO CA
95820-1527
US

V. Phone/Fax

Practice location:
  • Phone: 916-874-9670
  • Fax:
Mailing address:
  • Phone: 619-459-6120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number519676
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: