Healthcare Provider Details

I. General information

NPI: 1306086731
Provider Name (Legal Business Name): MRS. VERONICA MARIE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17271 EL CAMINO RD
MADERA CA
93636-1427
US

IV. Provider business mailing address

17271 EL CAMINO RD
MADERA CA
93636-1427
US

V. Phone/Fax

Practice location:
  • Phone: 559-250-0134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN90622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: