Healthcare Provider Details

I. General information

NPI: 1740460724
Provider Name (Legal Business Name): MR. ARIEL NED ESPIRITU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 SERENO DR
VALLEJO CA
94589-2441
US

IV. Provider business mailing address

387 NANCY CIR
VACAVILLE CA
95687-6669
US

V. Phone/Fax

Practice location:
  • Phone: 707-651-1312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number2211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: