Provider Demographics
NPI:1780961698
Name:ESQUIVEL, JOHN (LVN)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 E ORANGETHORPE AVE APT E105
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-1564
Mailing Address - Country:US
Mailing Address - Phone:714-747-5702
Mailing Address - Fax:714-485-2807
Practice Address - Street 1:5601 E ORANGETHORPE AVE APT E105
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1564
Practice Address - Country:US
Practice Address - Phone:714-747-5702
Practice Address - Fax:714-485-2807
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-05
Last Update Date:2011-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN262105311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility