Healthcare Provider Details

I. General information

NPI: 1073396107
Provider Name (Legal Business Name): ADRIANNA MICHELLE ESQUIVEL RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ADRIANNA MICHELLE FUENTES

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CALLE AMANECER
SAN CLEMENTE CA
92673-6214
US

IV. Provider business mailing address

26081 MERIT CIR STE 107
LAGUNA HILLS CA
92653-7017
US

V. Phone/Fax

Practice location:
  • Phone: 949-498-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-23-290993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: