Provider Demographics
NPI:1073202370
Name:ESQUIVEL, TATIANA BELEN
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:BELEN
Last Name:ESQUIVEL
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 1:16885 W BERNARDO DR STE 245
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1619
Mailing Address - Country:US
Mailing Address - Phone:858-946-6887
Mailing Address - Fax:
Practice Address - Street 1:16885 W BERNARDO DR STE 245
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1619
Practice Address - Country:US
Practice Address - Phone:858-946-6887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health