Provider Demographics
NPI:1194438614
Name:ESCALA, ANGELICA TAYLOR
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:TAYLOR
Last Name:ESCALA
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 1:11839 ASHWORTH ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4110
Mailing Address - Country:US
Mailing Address - Phone:424-376-4109
Mailing Address - Fax:
Practice Address - Street 1:12399 LEWIS ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-4682
Practice Address - Country:US
Practice Address - Phone:714-750-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician