Provider Demographics
NPI:1093037715
Name:GUTIERREZ ESCALANTE, NINOSKA
Entity type:Individual
Prefix:MRS
First Name:NINOSKA
Middle Name:
Last Name:GUTIERREZ ESCALANTE
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 1:501 N 4TH ST APT 142
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-3610
Mailing Address - Country:US
Mailing Address - Phone:626-345-4571
Mailing Address - Fax:
Practice Address - Street 1:501 N 4TH ST APT 142
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3610
Practice Address - Country:US
Practice Address - Phone:626-345-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist