Provider Demographics
NPI:1902045727
Name:ESPINOLA, MICHELLE S (BA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:ESPINOLA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-4718
Mailing Address - Country:US
Mailing Address - Phone:209-205-1058
Mailing Address - Fax:209-205-1062
Practice Address - Street 1:642 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4718
Practice Address - Country:US
Practice Address - Phone:209-205-1058
Practice Address - Fax:209-205-1062
Is Sole Proprietor?:No
Enumeration Date:2009-02-18
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program