Provider Demographics
NPI:1841087186
Name:ESCALANTE, SELINA MARIE
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:MARIE
Last Name:ESCALANTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7095
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0095
Mailing Address - Country:US
Mailing Address - Phone:209-774-5263
Mailing Address - Fax:209-478-3717
Practice Address - Street 1:PO BOX 7095
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95267-0095
Practice Address - Country:US
Practice Address - Phone:209-774-5263
Practice Address - Fax:209-478-3717
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker