Provider Demographics
NPI:1689954612
Name:ESPIRITU, YVETTE M (PA-C)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 EASTLAKE PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4521
Mailing Address - Country:US
Mailing Address - Phone:619-482-0300
Mailing Address - Fax:619-482-0959
Practice Address - Street 1:890 EASTLAKE PKWY STE 205
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4521
Practice Address - Country:US
Practice Address - Phone:619-482-0300
Practice Address - Fax:619-482-0959
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21703363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant