Provider Demographics
NPI:1548080922
Name:XTENDED ARMS
Entity type:Organization
Organization Name:XTENDED ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPADRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-362-9116
Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-4328
Mailing Address - Country:US
Mailing Address - Phone:510-362-9116
Mailing Address - Fax:
Practice Address - Street 1:1111 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4841
Practice Address - Country:US
Practice Address - Phone:510-362-9116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health