Healthcare Provider Details

I. General information

NPI: 1710842000
Provider Name (Legal Business Name): ANTONIO ESPINOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 CALIFORNIA AVE
PALO ALTO CA
94306-1603
US

IV. Provider business mailing address

300 DAVEY GLEN RD APT 3423
BELMONT CA
94002-2109
US

V. Phone/Fax

Practice location:
  • Phone: 650-328-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number71220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: