Healthcare Provider Details

I. General information

NPI: 1104352111
Provider Name (Legal Business Name): MEGHAN ESCOTO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 08/05/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93561 20111 W VALLEY BLVD
TEHACHAPI CA
93561
US

IV. Provider business mailing address

20111 W VALLEY BLVD
TEHACHAPI CA
93561-8747
US

V. Phone/Fax

Practice location:
  • Phone: 661-238-0600
  • Fax: 661-836-5088
Mailing address:
  • Phone: 661-238-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95006575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: