Healthcare Provider Details

I. General information

NPI: 1043024938
Provider Name (Legal Business Name): SANDRA MARIZOL ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 DAKOTA AVE STE 9
SOUTH SIOUX CITY NE
68776-3696
US

IV. Provider business mailing address

3201 MAPLEWOOD ST
SIOUX CITY IA
51104-2236
US

V. Phone/Fax

Practice location:
  • Phone: 402-518-2755
  • Fax:
Mailing address:
  • Phone: 470-651-0361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: