Provider Demographics
NPI:1437475886
Name:ESPINA, SHEILA DEVELOS (DPT)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:DEVELOS
Last Name:ESPINA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7602
Mailing Address - Country:US
Mailing Address - Phone:949-340-6927
Mailing Address - Fax:949-215-7246
Practice Address - Street 1:24422 AVENIDA DE LA CARLOTA
Practice Address - Street 2:SUITE 190
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7602
Practice Address - Country:US
Practice Address - Phone:949-340-6927
Practice Address - Fax:949-215-7246
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33000225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1508936626Medicaid
CAPT33000OtherPT LICENSE
W19562Medicare PIN
CA1508936626Medicaid
CA6215970001Medicare NSC
CAPT33000OtherPT LICENSE