Healthcare Provider Details

I. General information

NPI: 1932560158
Provider Name (Legal Business Name): MARIA GUADALUPE ESQUIVEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N 300 E
CEDAR CITY UT
84720-2620
US

IV. Provider business mailing address

576 W 1045 N APT A3
CEDAR CITY UT
84721-5195
US

V. Phone/Fax

Practice location:
  • Phone: 435-586-6654
  • Fax:
Mailing address:
  • Phone: 805-610-7759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: