Healthcare Provider Details

I. General information

NPI: 1104573799
Provider Name (Legal Business Name): VANESSA A ESGUERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 CIVIC CENTER DR UNIT 1
SANTA CLARA CA
95050-4676
US

IV. Provider business mailing address

1420 CIVIC CENTER DR UNIT 1
SANTA CLARA CA
95050-4676
US

V. Phone/Fax

Practice location:
  • Phone: 408-416-6710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246R00000X
TaxonomyPathology Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: