Healthcare Provider Details

I. General information

NPI: 1285175919
Provider Name (Legal Business Name): JENNIFER QUIROZ ESCALERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 GATEWAY PL
SAN JOSE CA
95110-1010
US

IV. Provider business mailing address

2001 GATEWAY PL
SAN JOSE CA
95110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 831-809-8642
  • Fax:
Mailing address:
  • Phone: 831-809-8642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberD3663660
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: