Provider Demographics
NPI:1275380867
Name:ESCOBAR, KASANDRA (CHW)
Entity type:Individual
Prefix:
First Name:KASANDRA
Middle Name:
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 SCHILLING PL
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4543
Mailing Address - Country:US
Mailing Address - Phone:831-784-2162
Mailing Address - Fax:
Practice Address - Street 1:1441 SCHILLING PL
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4543
Practice Address - Country:US
Practice Address - Phone:831-784-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator