Healthcare Provider Details

I. General information

NPI: 1033743380
Provider Name (Legal Business Name): JOANNA VIOLET ESPLANA DE MESA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SUMMIT ST
OAKLAND CA
94609-3412
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-869-8865
  • Fax: 510-869-6271
Mailing address:
  • Phone: 510-869-6281
  • Fax: 510-869-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95014048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: