Healthcare Provider Details

I. General information

NPI: 1235968439
Provider Name (Legal Business Name): EILEEN DAISY ESPARZA-HUERTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27206 CALAROGA AVE STE 107
HAYWARD CA
94545-4300
US

IV. Provider business mailing address

27206 CALAROGA AVE STE 107
HAYWARD CA
94545-4300
US

V. Phone/Fax

Practice location:
  • Phone: 510-881-5291
  • Fax: 844-830-2655
Mailing address:
  • Phone: 510-881-5291
  • Fax: 844-830-2655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: