Provider Demographics
NPI:1801619804
Name:ESPARZA, VERANIA TERESA (CPHT)
Entity type:Individual
Prefix:
First Name:VERANIA
Middle Name:TERESA
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 MCCOOK WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-6427
Mailing Address - Country:US
Mailing Address - Phone:209-594-1866
Mailing Address - Fax:
Practice Address - Street 1:2959 MCCOOK WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-6427
Practice Address - Country:US
Practice Address - Phone:209-594-1866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATCH197396183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician