Healthcare Provider Details

I. General information

NPI: 1841037835
Provider Name (Legal Business Name): JORGE ESPIRITU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 MARCONI AVE
SACRAMENTO CA
95821-3867
US

IV. Provider business mailing address

3815 MARCONI AVE
SACRAMENTO CA
95821-3867
US

V. Phone/Fax

Practice location:
  • Phone: 916-890-3000
  • Fax:
Mailing address:
  • Phone: 916-890-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-GEBIJX
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: