Healthcare Provider Details

I. General information

NPI: 1548170822
Provider Name (Legal Business Name): JACQUELINE ESPARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4111 LAS VIRGENES RD
CALABASAS CA
91302-1886
US

IV. Provider business mailing address

24275 HATTERAS ST
WOODLAND HILLS CA
91367-3936
US

V. Phone/Fax

Practice location:
  • Phone: 805-218-0263
  • Fax:
Mailing address:
  • Phone: 805-218-0263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number23044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: