Provider Demographics
NPI:1982870739
Name:EKONG, ESTHER U
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:U
Last Name:EKONG
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 1:250 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-3333
Mailing Address - Country:US
Mailing Address - Phone:323-759-6963
Mailing Address - Fax:323-759-6991
Practice Address - Street 1:250 W 85TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-3333
Practice Address - Country:US
Practice Address - Phone:323-759-6963
Practice Address - Fax:323-759-6991
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5893101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor