Provider Demographics
NPI:1164161774
Name:ESPARZA, ALEXIS DANIELA
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:DANIELA
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 NORTHWOOD DR UNIT I
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-7712
Mailing Address - Country:US
Mailing Address - Phone:925-214-8922
Mailing Address - Fax:
Practice Address - Street 1:3540 NORTHWOOD DR UNIT I
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7712
Practice Address - Country:US
Practice Address - Phone:925-214-8922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer