Provider Demographics
NPI:1174275705
Name:ESQUIVEL, VINCENT JR (RADT)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:ESQUIVEL
Suffix:JR
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 W CAMPUS AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-1890
Mailing Address - Country:US
Mailing Address - Phone:559-602-5263
Mailing Address - Fax:
Practice Address - Street 1:1731 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6232
Practice Address - Country:US
Practice Address - Phone:559-732-4885
Practice Address - Fax:559-732-8289
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1403210820101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)