Individual
VIVIAN ESCAMILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
453 S INDIANA ST, LOS ANGELES, CA 90063-3908
(323) 266-7725
Mailing address
531 S CORAL AVE, COMPTON, CA 90220-3619
(323) 266-7725
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
190081GN
CA
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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