Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053712497 |
---|---|
Provider Name | Jennifer Esfandi |
First Address | Long Beach, CA 90806-5501 |
Second Address | Long Beach, CA 90806-5501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 04/09/2014 |