Healthcare Provider Details

I. General information

NPI: 1144802976
Provider Name (Legal Business Name): MARY JOYCE ESPINOZA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY JOYCE VIRAY

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5957 W RAMSEY ST
BANNING CA
92220-3058
US

IV. Provider business mailing address

5957 W RAMSEY ST
BANNING CA
92220-3058
US

V. Phone/Fax

Practice location:
  • Phone: 951-845-0313
  • Fax:
Mailing address:
  • Phone: 626-445-1284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: