1114054731 NPI number — KRISTEEN FRANCEEN ESQUIBEL CCDC

Table of content: KRISTEEN FRANCEEN ESQUIBEL CCDC (NPI 1114054731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114054731 NPI number — KRISTEEN FRANCEEN ESQUIBEL CCDC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESQUIBEL
Provider First Name:
KRISTEEN
Provider Middle Name:
FRANCEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CCDC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PRIETO
Provider Other First Name:
KRISTEEN
Provider Other Middle Name:
FRANCEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CCDC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1114054731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2080 CENTURY PARK E
Provider Second Line Business Mailing Address:
SUITE 1802
Provider Business Mailing Address City Name:
CENTURY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90067-2001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-553-9500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11900 S. AVALON BLVD.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-242-0500
Provider Business Practice Location Address Fax Number:
323-242-0600
Provider Enumeration Date:
02/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  101YA0400X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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