Active NPI
Addy Escobedo
- Assisted Living Facility
- Apple Valley, CA
National Provider Identifier
1063307940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 361881127
- Practice address
- 14186 Cuyamaca Rd
Apple Valley, CA 92307-5935 - Phone
- (323) 350-2415
- Fax
- (323) 350-2415
- NPI assigned
- Jun 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 361881127 | CA | Primary |
Addresses
Primary practice location
14186 Cuyamaca Rd
Apple Valley, CA 92307-5935
Mailing address
512 Holladay PL
Rialto, CA 92376-5706
Phone (323) 984-3429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 361881127 | CA | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1063307940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 HOLLADAY PL",
"city": "RIALTO",
"state": "CA",
"postal_code": "923765706",
"telephone_number": "323-984-3429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14186 CUYAMACA RD",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923075935",
"telephone_number": "323-350-2415",
"fax_number": "323-350-2415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESCOBEDO",
"first_name": "ADDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-11",
"last_updated": "2025-06-11",
"certification_date": "2025-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "CA",
"license": "361881127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.