Provider Demographics
NPI:1831887595
Name:NUNEZ ESPINOZA, ANDRES ENRIQUE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:ENRIQUE
Last Name:NUNEZ ESPINOZA
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 5TH ST STE 132
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6584
Mailing Address - Country:US
Mailing Address - Phone:424-299-9767
Mailing Address - Fax:
Practice Address - Street 1:2690 5TH ST STE 132
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6584
Practice Address - Country:US
Practice Address - Phone:424-299-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48474225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist