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Individual

LILIA LUCY ESQUEDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2773
(909) 388-9191
Mailing address
18461 DRAGONERA DR, ROWLAND HEIGHTS, CA 91748-4720
(626) 483-5644

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36040
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124100383
CA
Enumeration date
12/14/2011
Last updated
12/14/2011
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