Provider Demographics
NPI:1881367159
Name:MOOR, VICTORIA ESCOBAR (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ESCOBAR
Last Name:MOOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14532 VOLTAIRE DR
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93225-9520
Mailing Address - Country:US
Mailing Address - Phone:951-719-7911
Mailing Address - Fax:
Practice Address - Street 1:12598 CENTRAL AVE STE 213
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-3530
Practice Address - Country:US
Practice Address - Phone:888-710-1045
Practice Address - Fax:888-710-1046
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95017550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily