Provider Demographics
NPI:1104563907
Name:CORDOVA, ESPERANZA (RCP)
Entity type:Individual
Prefix:MISS
First Name:ESPERANZA
Middle Name:
Last Name:CORDOVA
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 DONALD LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-2057
Mailing Address - Country:US
Mailing Address - Phone:925-864-7545
Mailing Address - Fax:
Practice Address - Street 1:1652 MONO AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2020
Practice Address - Country:US
Practice Address - Phone:510-481-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41359227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered