Healthcare Provider Details

I. General information

NPI: 1144144213
Provider Name (Legal Business Name): FERNANDA ESCOBAR GONZALEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 LAS VEGAS BLVD N # 2A
LAS VEGAS NV
89115-0598
US

IV. Provider business mailing address

3732 GALLOWTREE AVE
NORTH LAS VEGAS NV
89081-6641
US

V. Phone/Fax

Practice location:
  • Phone: 702-547-6971
  • Fax:
Mailing address:
  • Phone: 702-547-6971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT6317
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: