Provider Demographics
NPI:1841805793
Name:ESQUIVEL, HANNAH NICOLE (RADT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:NICOLE
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20700 SAN JOSE HILLS RD APT 168
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1308
Mailing Address - Country:US
Mailing Address - Phone:209-347-6917
Mailing Address - Fax:
Practice Address - Street 1:18612 SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:CA
Practice Address - Zip Code:92316-2639
Practice Address - Country:US
Practice Address - Phone:909-421-7120
Practice Address - Fax:909-421-7128
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374700000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No374700000XNursing Service Related ProvidersTechnician