Provider Demographics
NPI:1609409812
Name:ESCOTO, MARY EVE ADELINE TORRES (PT)
Entity Type:Individual
Prefix:
First Name:MARY EVE ADELINE
Middle Name:TORRES
Last Name:ESCOTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8309 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1511
Mailing Address - Country:US
Mailing Address - Phone:267-887-8585
Mailing Address - Fax:
Practice Address - Street 1:10605 BALBOA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6358
Practice Address - Country:US
Practice Address - Phone:818-832-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty