Provider Demographics
NPI:1285945576
Name:ESGUERRA, JETHRO JOHN V (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:JETHRO JOHN
Middle Name:V
Last Name:ESGUERRA
Suffix:
Gender:M
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W OCEAN BLVD
Mailing Address - Street 2:APT 1909
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-7939
Mailing Address - Country:US
Mailing Address - Phone:562-631-5017
Mailing Address - Fax:
Practice Address - Street 1:1655 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5801
Practice Address - Country:US
Practice Address - Phone:323-737-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19908363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily