Provider Demographics
NPI:1659007300
Name:ESPINO, BEATRIZ (LVN, CPSP EDUCATOR)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:ESPINO
Suffix:
Gender:F
Credentials:LVN, CPSP EDUCATOR
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:
Other - Last Name:ESPINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCN
Mailing Address - Street 1:333 LAWS AVE
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-6540
Mailing Address - Country:US
Mailing Address - Phone:707-468-1010
Mailing Address - Fax:707-468-7958
Practice Address - Street 1:333 LAWS AVE
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-6540
Practice Address - Country:US
Practice Address - Phone:707-468-1010
Practice Address - Fax:707-472-4502
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA692100164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1811958952Medicaid