Provider Demographics
NPI:1568741270
Name:ESQUIVEL, KRISTINA DIANNE (LCSW, CPRP)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:DIANNE
Last Name:ESQUIVEL
Suffix:
Gender:F
Credentials:LCSW, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 603
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92842-0603
Mailing Address - Country:US
Mailing Address - Phone:657-296-2584
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 603
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92842-0603
Practice Address - Country:US
Practice Address - Phone:657-296-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
CA230456101YM0800X
CA1265431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health