Healthcare Provider Details

I. General information

NPI: 1952835258
Provider Name (Legal Business Name): HILARY N ESPANA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 OLD PLACERVILLE RD STE 100
SACRAMENTO CA
95827-2539
US

IV. Provider business mailing address

729 SUNRISE AVE #602
ROSEVILLE CA
95661
US

V. Phone/Fax

Practice location:
  • Phone: 800-470-0071
  • Fax:
Mailing address:
  • Phone: 888-543-2243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number54350
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: