Healthcare Provider Details

I. General information

NPI: 1720216104
Provider Name (Legal Business Name): ARACELI ESPARZA-JAUREGUI M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 SOUTH SEPULVEDA BLVD
CULVER CITY CA
90230
US

IV. Provider business mailing address

7039 N 84TH AVE
GLENDALE AZ
85305-6994
US

V. Phone/Fax

Practice location:
  • Phone: 310-895-2304
  • Fax:
Mailing address:
  • Phone: 818-424-5870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-15897
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC-3880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: