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General NPI Number Information
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NPI Number | 1366932238
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Entity Type | Individual
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Provider Name | CECILIA RAQUEL ESCOBEDO NP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 14362 RAMONA BLVD
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City | BALDWIN PARK
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State | CA
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Zip | 91706-3241
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Country | US
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Telephone | 626-315-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 N HARTLEY AVE
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City | COVINA
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State | CA
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Zip | 91722-3914
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Country | US
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Telephone | 626-315-6270
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP95008219
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | NP95008219
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License Number State | CA
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