Basic Information
| Provider Information | |||||||||
| NPI: | 1730706722 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESCALERA | ||||||||
| FirstName: | SONIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | RDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 CHANNING WAY | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932211910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596241177 | ||||||||
| FaxNumber: | 5598541013 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S CHINOWTH ST | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932771653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596241177 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2020 | ||||||||
| LastUpdateDate: | 07/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 126800000X | Y | Dental Providers | Dental Assistant |
No ID Information.