Provider Demographics
NPI:1376698225
Name:ESCOBAR, LETICIA AGUARISTI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LETICIA
Middle Name:AGUARISTI
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 E CALAVERAS BLVD
Mailing Address - Street 2:KAISER-PSYCHIATRY DEPT.
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5491
Mailing Address - Country:US
Mailing Address - Phone:408-945-2915
Mailing Address - Fax:
Practice Address - Street 1:611 S MILPITAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5473
Practice Address - Country:US
Practice Address - Phone:408-945-2915
Practice Address - Fax:408-945-5007
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS94001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical