Provider Demographics
NPI:1700906849
Name:ESCAMILLA, SONIA LOURDES (ASW 12458)
Entity Type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:LOURDES
Last Name:ESCAMILLA
Suffix:
Gender:F
Credentials:ASW 12458
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3487 BARCA ST
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3907
Mailing Address - Country:US
Mailing Address - Phone:805-484-5494
Mailing Address - Fax:
Practice Address - Street 1:1911 WILLIAMS DR STE 150
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-8460
Practice Address - Fax:805-981-8461
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical