Provider Demographics
NPI:1275215881
Name:SANCHEZ-TAVIO, ESTHER LIZETTE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:LIZETTE
Last Name:SANCHEZ-TAVIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6219 LAKE ARAGO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-3504
Mailing Address - Country:US
Mailing Address - Phone:619-829-9398
Mailing Address - Fax:
Practice Address - Street 1:1351 BROADWAY
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5811
Practice Address - Country:US
Practice Address - Phone:619-383-6703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025791363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care