Individual
ESTEBAN VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
Mailing address
4164 BROCKTON AVE, RIVERSIDE, CA 92501-3400
(951) 683-5193
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-FTHGML
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
04/30/2025
Last updated
09/23/2025
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