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General NPI Number Information
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NPI Number | 1881367159
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Entity Type | Individual
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Provider Name | VICTORIA ESCOBAR MOOR FNP
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Gender | Female
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Dates
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Enumeration Date | 07/31/2021
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Last Update Date | 07/31/2021
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Provider Practice Location Address
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Address Line | 12598 CENTRAL AVE STE 213
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City | CHINO
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State | CA
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Zip | 91710-3530
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Country | US
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Telephone | 888-710-1045
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Fax | 888-710-1046
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Provider Business Mailing Address
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Address Line | 14532 VOLTAIRE DR
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City | FRAZIER PARK
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State | CA
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Zip | 93225-9520
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Country | US
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Telephone | 951-719-7911
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95017550
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License Number State | CA
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