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General NPI Number Information
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NPI Number | 1841805793
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Entity Type | Individual
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Provider Name | HANNAH NICOLE ESQUIVEL RADT
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Gender | Female
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 18612 SANTA ANA AVE
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City | BLOOMINGTON
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State | CA
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Zip | 92316-2639
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Country | US
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Telephone | 909-421-7120
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Fax | 909-421-7128
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Provider Business Mailing Address
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Address Line | 20700 SAN JOSE HILLS RD APT 168
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City | WALNUT
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State | CA
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Zip | 91789-1308
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Country | US
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Telephone | 209-347-6917
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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 | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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