Provider Demographics
NPI:1508226929
Name:TACOTACO ESPIRITU, CHRISTINE (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TACOTACO ESPIRITU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 AUTUMN DR
Mailing Address - Street 2:#239
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2885
Mailing Address - Country:US
Mailing Address - Phone:209-740-2704
Mailing Address - Fax:
Practice Address - Street 1:1958 VIA CTR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6056
Practice Address - Country:US
Practice Address - Phone:760-477-1350
Practice Address - Fax:760-754-6785
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2911692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic