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General NPI Number Information
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NPI Number | 1174082663
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Entity Type | Individual
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Provider Name | RUBEN ERNESTO ESCAMILLA M.A. CLINICAL PSYC
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Gender | Male
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 508 S 2ND AVE
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City | COVINA
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State | CA
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Zip | 91723-3012
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Country | US
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Telephone | 626-974-8123
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Fax | 626-974-8198
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Provider Business Mailing Address
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Address Line | 457 KNOLLCREST DR STE 120
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City | REDDING
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State | CA
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Zip | 96002-0121
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Country | US
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Telephone | 707-703-5600
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Fax | 530-232-0923
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 144166
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License Number State | CA
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