Provider Demographics
NPI:1275586752
Name:GAYOBA, ESTHER TERESA (PA-C)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:TERESA
Last Name:GAYOBA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 ORION WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-1713
Mailing Address - Country:US
Mailing Address - Phone:904-625-4310
Mailing Address - Fax:
Practice Address - Street 1:3750 AUBURN BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2134
Practice Address - Country:US
Practice Address - Phone:916-487-8230
Practice Address - Fax:916-731-7915
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15025363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA386944050AMedicaid
FL2928574-00Medicaid
FLAE368YMedicare PIN
FLAE368XMedicare UPIN
CAQ23933Medicare UPIN
FLAE368WMedicare UPIN
GA386944050AMedicaid
FL2928574-00Medicaid
FLBR885AMedicare PIN
FLBR885BMedicare PIN