Healthcare Provider Details

I. General information

NPI: 1366163032
Provider Name (Legal Business Name): HANNIA ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 E BIANCHI RD APT 1
STOCKTON CA
95207-7721
US

IV. Provider business mailing address

2291 W MARCH LN STE C101
STOCKTON CA
95207-6669
US

V. Phone/Fax

Practice location:
  • Phone: 209-507-6136
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: