Provider Demographics
NPI:1689870719
Name:ESCOBAR, NANCY E
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:ESCOBAR
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 1:660 S FAIROAKS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7913
Mailing Address - Country:US
Mailing Address - Phone:408-992-4800
Mailing Address - Fax:408-992-4801
Practice Address - Street 1:660 S FAIROAKS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-7913
Practice Address - Country:US
Practice Address - Phone:408-992-4800
Practice Address - Fax:408-992-4801
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26887167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician