Basic Information
Provider Information
NPI: 1710425376
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESQUIVIAS
FirstName: CINDY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Practice Location
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/03/2017
LastUpdateDate: 04/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X CAN Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
235Z00000X26618CAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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