Most Relevant Information
Provider Data
| NPI Number: | 1003580671 |
| Provider Name: | KELLEY ESCAMILLA LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 101874 |
Most Important Dates
| Enumeration Date: | 08/05/2021 |
| Last Updated: | 07/30/2023 |
Provider Practice Location
22994 EL TORO RD STE 109
LAKE FOREST
CA
926304961
Practice Location Phone/Fax
| Phone: | 7148867366 |
| Fax: |
Provider Mailing Location
PO BOX 27822
SANTA ANA
CA
927997822
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |