Provider Demographics
NPI:1508181413
Name:ESPITIA, CARINA GONZOLEZ
Entity Type:Individual
Prefix:MS
First Name:CARINA
Middle Name:GONZOLEZ
Last Name:ESPITIA
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 1:4705 N SONORA AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3966
Mailing Address - Country:US
Mailing Address - Phone:559-276-7558
Mailing Address - Fax:559-276-7568
Practice Address - Street 1:4705 N SONORA AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3966
Practice Address - Country:US
Practice Address - Phone:559-276-7558
Practice Address - Fax:559-276-7568
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD3720946OtherDRIVER LICENSE