Provider Demographics
NPI:1770974537
Name:ESCOE, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ESCOE
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 1:37500 PLANTAIN LN
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-6956
Mailing Address - Country:US
Mailing Address - Phone:661-944-7574
Mailing Address - Fax:
Practice Address - Street 1:37500 PLANTAIN LN
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-6956
Practice Address - Country:US
Practice Address - Phone:661-944-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA234881164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse