MEDICARE: YOLANDA EDITH ESCOTO

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	224Z00000X	Occupational Therapy Assistant	OTA314	CA

General Provider Information

NPI Number	:	1821985979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA EDITH ESCOTO

Provider Business Mailing Address
First Line	:	1400 RIDGEBACK RD APT C
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91910-6917
Country	:	US
Telephone Number	:	619-634-0699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 RIDGEBACK RD APT C
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91910-6917
Country	:	US
Telephone Number	:	619-634-0699
Fax Number	:

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

Provider Enumeration Date	:	06/20/2025
Last Update Date	:	06/20/2025

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Directions to “ YOLANDA EDITH ESCOTO ” Practice Location

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