Healthcare Provider Details

I. General information

NPI: 1346652518
Provider Name (Legal Business Name): FRANCISCO ANTONIO ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 VIENNA ST
SAN FRANCISCO CA
94112-2127
US

IV. Provider business mailing address

239 VIENNA ST
SAN FRANCISCO CA
94112-2127
US

V. Phone/Fax

Practice location:
  • Phone: 415-902-9352
  • Fax:
Mailing address:
  • Phone: 415-902-9352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberASW67838
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: