MEDICARE: DR. SHEILA DEVELOS ESPINA D.P.T.

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	225100000X	Physical Therapist	PT33000	CA
2	2251G0304X	Geriatric Physical Therapist	PT33000	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	PT33000	OTHER	CA	PT LICENSE

General Provider Information

NPI Number	:	1437475886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEILA DEVELOS ESPINA D.P.T.

Provider Business Mailing Address
First Line	:	24422 AVENIDA DE LA CARLOTA
Second Line	:	SUITE 190
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-7602
Country	:	US
Telephone Number	:	949-340-6927
Fax Number	:	949-215-7246

Provider Business Practice Location Address
First Line	:	24422 AVENIDA DE LA CARLOTA
Second Line	:	SUITE 190
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-7602
Country	:	US
Telephone Number	:	949-340-6927
Fax Number	:	949-215-7246

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

Provider Enumeration Date	:	04/09/2010
Last Update Date	:	02/01/2011

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Directions to “ DR. SHEILA DEVELOS ESPINA D.P.T.” Practice Location

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