Provider Demographics
NPI:1952870115
Name:ESQUIVEL, CHRISTIE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:SAKATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:197 E CAROLINE ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3731
Mailing Address - Country:US
Mailing Address - Phone:909-558-3636
Mailing Address - Fax:
Practice Address - Street 1:197 E CAROLINE ST STE 1400
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3731
Practice Address - Country:US
Practice Address - Phone:909-558-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-17
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58435363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical