Healthcare Provider Details

I. General information

NPI: 1508778838
Provider Name (Legal Business Name): NATALIE ROSE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4170 N 108TH AVE
PHOENIX AZ
85037-5469
US

IV. Provider business mailing address

3518 N 105TH LN
AVONDALE AZ
85392-4434
US

V. Phone/Fax

Practice location:
  • Phone: 480-751-1957
  • Fax:
Mailing address:
  • Phone: 602-619-3398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: