Provider Demographics
NPI:1558682369
Name:ESCOBAR, LAURA KRISTINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:KRISTINE
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39001 SUNDALE DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2005
Mailing Address - Country:US
Mailing Address - Phone:510-818-6360
Mailing Address - Fax:510-574-4805
Practice Address - Street 1:39001 SUNDALE DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2005
Practice Address - Country:US
Practice Address - Phone:510-818-6360
Practice Address - Fax:510-574-4805
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator