Provider Demographics
NPI:1639776974
Name:ESAU, AYANA CAPRI
Entity Type:Individual
Prefix:MISS
First Name:AYANA
Middle Name:CAPRI
Last Name:ESAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 TAFT DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-4160
Mailing Address - Country:US
Mailing Address - Phone:757-975-3724
Mailing Address - Fax:
Practice Address - Street 1:414 TAFT DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-4160
Practice Address - Country:US
Practice Address - Phone:757-975-3724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator