Provider Demographics
NPI:1659678712
Name:ESQUIVEL-ACOSTA, JAVIER (PA)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:ESQUIVEL-ACOSTA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 S WHITE RD
Mailing Address - Street 2:SUITE 95
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2076
Mailing Address - Country:US
Mailing Address - Phone:408-223-8080
Mailing Address - Fax:408-223-8088
Practice Address - Street 1:2690 S WHITE RD
Practice Address - Street 2:SUITE 95
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2076
Practice Address - Country:US
Practice Address - Phone:408-223-8080
Practice Address - Fax:408-223-8088
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1091854363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551869Medicare PIN