Provider Demographics
NPI:1598805103
Name:ESCOBAR, SANDRA ELIZABETH (PHD)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3959 POPPYSEED PL
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2947
Mailing Address - Country:US
Mailing Address - Phone:818-878-0431
Mailing Address - Fax:
Practice Address - Street 1:1151 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1828
Practice Address - Country:US
Practice Address - Phone:213-639-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15771103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical