Healthcare Provider Details

I. General information

NPI: 1538669247
Provider Name (Legal Business Name): DALIA ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 N MAIN ST STE 305
SANTA ANA CA
92705-6693
US

IV. Provider business mailing address

18726 S WESTERN AVE STE 408
GARDENA CA
90248-3858
US

V. Phone/Fax

Practice location:
  • Phone: 949-357-2556
  • Fax: 855-568-2494
Mailing address:
  • Phone: 310-856-0800
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: