Provider Demographics
NPI:1164061875
Name:ESPERANTE, JOSUE (MA)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:ESPERANTE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:JOSUE
Other - Middle Name:
Other - Last Name:DOMENECH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:5051 CANYON CREST DR STE 204
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-6035
Mailing Address - Country:US
Mailing Address - Phone:951-682-1488
Mailing Address - Fax:
Practice Address - Street 1:5051 CANYON CREST DR STE 204
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-6035
Practice Address - Country:US
Practice Address - Phone:951-682-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program