Individual provider Active NPI

Berenice Magally Escobedo, LBSW

  • Case Manager/Care Coordinator
  • San Antonio, TX
National Provider Identifier
1790836005
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
36621 Issued in TX
Practice address
9006 Saint Julien CT
San Antonio, TX 78240-3538
Phone
(210) 682-6530
Fax
(210) 682-3530
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 36621 TX Primary

Addresses

Primary practice location

9006 Saint Julien CT
San Antonio, TX 78240-3538

Mailing address

15111 Spring GLN
San Antonio, TX 78247-5403
Phone (210) 568-0436

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

LicenseStateTypeSpecialty
36621TXMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790836005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15111 SPRING GLN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782475403",
            "telephone_number": "210-568-0436",
            "fax_number": "210-745-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9006 SAINT JULIEN CT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403538",
            "telephone_number": "210-682-6530",
            "fax_number": "210-682-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBEDO",
        "first_name": "BERENICE",
        "middle_name": "MAGALLY",
        "name_prefix": "Mrs.",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "36621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.