Basic Information
Provider Information
NPI: 1437467057
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESQUIVIAS
FirstName: CAROLINA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18032 ERMANITA AVE
Address2:  
City: TORRANCE
State: CA
PostalCode: 905043905
CountryCode: US
TelephoneNumber: 3109774740
FaxNumber:  
Practice Location
Address1: 4211 AVALON BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900115622
CountryCode: US
TelephoneNumber: 3234325185
FaxNumber: 3234325086
Other Information
ProviderEnumerationDate: 09/16/2010
LastUpdateDate: 09/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X29721CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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