Healthcare Provider Details

I. General information

NPI: 1093417982
Provider Name (Legal Business Name): PATRICIA ESPARZA CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 CANYON CREST DR
RIVERSIDE CA
92507-6301
US

IV. Provider business mailing address

8720 SARANAC PL
RIVERSIDE CA
92508-2508
US

V. Phone/Fax

Practice location:
  • Phone: 951-686-2203
  • Fax: 951-686-4980
Mailing address:
  • Phone: 951-956-3858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number3148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: