Provider Demographics
NPI:1104818137
Name:ESPIRITU, JOCELYN IMPAS (MD)
Entity type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:IMPAS
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1441 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4405
Mailing Address - Country:US
Mailing Address - Phone:209-576-3735
Mailing Address - Fax:209-342-3007
Practice Address - Street 1:1441 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4405
Practice Address - Country:US
Practice Address - Phone:209-576-3735
Practice Address - Fax:209-342-3007
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA64533207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A645330Medicaid
CA00A645330Medicaid
CA00A645330Medicaid
CAH70789Medicare UPIN