Provider Demographics
NPI:1720888415
Name:ESPINOZA, JAIME ARON
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:ARON
Last Name:ESPINOZA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 BENSON AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-4206
Mailing Address - Country:US
Mailing Address - Phone:209-423-3454
Mailing Address - Fax:
Practice Address - Street 1:738 BENSON AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-4206
Practice Address - Country:US
Practice Address - Phone:209-423-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician