Provider Demographics
NPI:1043689292
Name:ESCOBAR, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 E. 4TH ST.
Mailing Address - Street 2:STE. 107
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-399-1860
Mailing Address - Fax:
Practice Address - Street 1:2112 E 4TH ST
Practice Address - Street 2:STE. 107
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3816
Practice Address - Country:US
Practice Address - Phone:714-399-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor