Healthcare Provider Details

I. General information

NPI: 1184910671
Provider Name (Legal Business Name): ERIKA ISABEL ESPARZA MFT-I, RRW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 WILLO LN
COSTA MESA CA
92627-4645
US

IV. Provider business mailing address

955 E 3RD ST UNIT 316
LONG BEACH CA
90802-6711
US

V. Phone/Fax

Practice location:
  • Phone: 949-313-1192
  • Fax:
Mailing address:
  • Phone: 949-836-7249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRW4190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: