Basic Information
Provider Information
NPI: 1235654591
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESQUIVEL
FirstName: FLORA
MiddleName: RITA
NamePrefix:  
NameSuffix:  
Credential: AMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3440 TORRANCE BLVD STE 104
Address2:  
City: TORRANCE
State: CA
PostalCode: 905035805
CountryCode: US
TelephoneNumber: 3107871335
FaxNumber: 3107871809
Practice Location
Address1: 3440 TORRANCE BLVD STE 104
Address2:  
City: TORRANCE
State: CA
PostalCode: 905035805
CountryCode: US
TelephoneNumber: 3107871335
FaxNumber: 3107871809
Other Information
ProviderEnumerationDate: 08/08/2017
LastUpdateDate: 07/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XLCI10071217CAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
106H00000X97224CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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