Healthcare Provider Details

I. General information

NPI: 1790578680
Provider Name (Legal Business Name): ANGELICA ESPARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 E SAN BERNARDINO RD
COVINA CA
91723-1704
US

IV. Provider business mailing address

414 E SAN BERNARDINO RD
COVINA CA
91723-1704
US

V. Phone/Fax

Practice location:
  • Phone: 626-367-3206
  • Fax:
Mailing address:
  • Phone: 626-367-3206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number9484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: