Provider Demographics
NPI:1063030047
Name:NARON, HOSPICIO ESCUDERO JR
Entity Type:Individual
Prefix:MR
First Name:HOSPICIO
Middle Name:ESCUDERO
Last Name:NARON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8445 CAMINO SANTA FE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2650
Mailing Address - Country:US
Mailing Address - Phone:619-541-3246
Mailing Address - Fax:
Practice Address - Street 1:8445 CAMINO SANTA FE STE 215
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2650
Practice Address - Country:US
Practice Address - Phone:619-541-3246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029272163WP0808X
CA95029615363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health