MEDICARE: MR. EDWARD ESPERANTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1306210240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD ESPERANTE

Provider Business Mailing Address
First Line	:	1309 MARSHALL ST
Second Line	:	#307
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-2547
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14895 E 14TH ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2922
Country	:	US
Telephone Number	:	510-346-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2015
Last Update Date	:	11/16/2015

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Directions to “ MR. EDWARD ESPERANTE ” Practice Location

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