Healthcare Provider Details

I. General information

NPI: 1710644059
Provider Name (Legal Business Name): NADIA ESPARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4980 HILLSDALE CIRCLE, EL DORADO HILLS CA 95762
EL DORADO HILLS CA
95667-9566
US

IV. Provider business mailing address

4980 HILLSDALE CIRCLE, EL DORADO HILLS CA 95762
EL DORADO HILLS CA
95667
US

V. Phone/Fax

Practice location:
  • Phone: 530-210-7307
  • Fax:
Mailing address:
  • Phone: 153-021-0730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: