Healthcare Provider Details

I. General information

NPI: 1639213804
Provider Name (Legal Business Name): JENNIFER DALMACIO ESPINOSA R.N., B.S.N
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

2174 CANAL AVE
LONG BEACH CA
90810-3563
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-8000
  • Fax: 562-826-8151
Mailing address:
  • Phone: 562-607-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number689774
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: