Healthcare Provider Details

I. General information

NPI: 1669542916
Provider Name (Legal Business Name): ARLENE D ESPIRITU O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 STONE BLVD STE 150
WEST SACRAMENTO CA
95691-4054
US

IV. Provider business mailing address

2226 P ST
SACRAMENTO CA
95816-6113
US

V. Phone/Fax

Practice location:
  • Phone: 916-372-3090
  • Fax:
Mailing address:
  • Phone: 510-541-9353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number13074T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: