Provider Demographics
NPI:1639340391
Name:ESPINOSA, JENNET
Entity Type:Individual
Prefix:
First Name:JENNET
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNET
Other - Middle Name:
Other - Last Name:SCHAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2827 TELEK PL APT 2212
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4874
Mailing Address - Country:US
Mailing Address - Phone:941-914-0308
Mailing Address - Fax:
Practice Address - Street 1:2729 KING ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-4008
Practice Address - Country:US
Practice Address - Phone:703-836-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008870225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist