Individual
DR. AZAHAR LOPEZ ESCAMILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
301 THE CITY DR S, ORANGE, CA 92868-3205
(714) 801-3739
Mailing address
PO BOX 1374, ORANGE, CA 92856-0374
(714) 801-3739
(714) 538-1108
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY16792
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY167920
MEDI-CAL
CA
Enumeration date
10/16/2006
Last updated
07/08/2007
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