MEDICARE: MS. SILVIA ESQUIVIAS 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
1	1041C0700X	Clinical Social Worker	LCS 22672	CA

General Provider Information

NPI Number	:	1396071718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SILVIA ESQUIVIAS LCSW

Provider Business Mailing Address
First Line	:	22459 SOUTHWALK ST
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92553-1822
Country	:	US
Telephone Number	:	951-208-0384
Fax Number	:

Provider Business Practice Location Address
First Line	:	22459 SOUTHWALK ST
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92553-1822
Country	:	US
Telephone Number	:	951-208-0384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2009
Last Update Date	:	10/19/2009

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