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NPI Code Detail

MEDICARE: MR. RYANN ESTEBAN LCSW

MEDICARE:  MR. RYANN  ESTEBAN  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1124156294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYANN ESTEBAN LCSW
Provider Business Mailing Address
First Line : 525 21ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94612-1605
Country : US
Telephone Number : 847-912-4509
Fax Number :
Provider Business Practice Location Address
First Line : 525 21ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94612-1605
Country : US
Telephone Number : 847-912-4509
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 12/08/2011

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Directions to “ MR. RYANN ESTEBAN LCSW” Practice Location

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