Healthcare Provider Details

I. General information

NPI: 1912404419
Provider Name (Legal Business Name): CHRISTON ESLINGER PTA, CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 I ST
LOS BANOS CA
93635-4143
US

IV. Provider business mailing address

9545 STATE HIGHWAY 152
DOS PALOS CA
93620-9755
US

V. Phone/Fax

Practice location:
  • Phone: 209-658-1778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number75177
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number8004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: