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NPI 1427933761

NPI 1427933761 : MICHELLE ESPERANZA STAPP : EUREKA, CA

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General NPI Number Information
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    NPI Number           |    1427933761
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    Entity Type          |    Individual 
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    Provider Name        |    MICHELLE ESPERANZA STAPP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2025
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    Last Update Date     |    08/06/2025
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Provider Practice Location Address
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    Address Line         |    611 3RD ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-0417
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    Country              |    US
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    Telephone            |    707-502-2359
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3304 D ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95503-5215
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    Country              |    US
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    Telephone            |    707-362-6624
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    99405
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    License Number State |    CA
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