Healthcare Provider Details

I. General information

NPI: 1881012136
Provider Name (Legal Business Name): FRANCISCO JAVIER ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 US HIGHWAY 22
MOUNTAINSIDE NJ
07092-2614
US

IV. Provider business mailing address

17 LACKAWANNA PL APT 509
BLOOMFIELD NJ
07003-2955
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-4460
  • Fax:
Mailing address:
  • Phone: 562-528-9783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01185100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: