Provider Demographics
NPI:1578064929
Name:ESQUIVEL, LUCILA (LMFT)
Entity Type:Individual
Prefix:
First Name:LUCILA
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-3258
Mailing Address - Country:US
Mailing Address - Phone:909-387-7408
Mailing Address - Fax:
Practice Address - Street 1:755 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-3258
Practice Address - Country:US
Practice Address - Phone:909-387-7792
Practice Address - Fax:909-387-7386
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116958106H00000X
390200000X
CA135373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program