Healthcare Provider Details

I. General information

NPI: 1306468681
Provider Name (Legal Business Name): KRYSTINA ESQUIBEL MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTINA BERTOLDI

II. Dates (important events)

Enumeration Date: 05/10/2020
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 N 2ND ST
SAN JOSE CA
95112-4015
US

IV. Provider business mailing address

1750 MERIDIAN AVE # 6263
SAN JOSE CA
95125-5545
US

V. Phone/Fax

Practice location:
  • Phone: 669-250-2219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC18494
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT127233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: