Provider Demographics
NPI:1124363726
Name:ESQUIVEL, EMANUEL LEWIS (LMFT)
Entity Type:Individual
Prefix:
First Name:EMANUEL
Middle Name:LEWIS
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 E OLD BADILLO ST # B3
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-3163
Mailing Address - Country:US
Mailing Address - Phone:626-251-2300
Mailing Address - Fax:
Practice Address - Street 1:1650 E OLD BADILLO ST # B3
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-3163
Practice Address - Country:US
Practice Address - Phone:626-251-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95572101YM0800X
225400000X, 390200000X
CA122087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program