Healthcare Provider Details

I. General information

NPI: 1689598609
Provider Name (Legal Business Name): ERNESTINE ESAMBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8825 STANFORD BLVD STE 390
COLUMBIA MD
21045-4754
US

IV. Provider business mailing address

8825 STANFORD BLVD STE 390
COLUMBIA MD
21045-4754
US

V. Phone/Fax

Practice location:
  • Phone: 410-200-9200
  • Fax: 414-412-8494
Mailing address:
  • Phone: 410-200-9200
  • Fax: 414-412-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: