Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 4210 | OH |
Y | 225200000X | Physical Therapy Assistant | 8584 | CA |
NPI | 1013186600 |
---|---|
Provider Name | Eric James Espiritu |
First Address | Simi Valley, CA 93063-6582 |
Second Address | Woodland Hills, CA 91365-4084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 27/02/2008 |