Healthcare Provider Details

I. General information

NPI: 1962566836
Provider Name (Legal Business Name): DENISE ANGELA ESPINOSA L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 SOUTH L ST
DINUBA CA
93618-3000
US

IV. Provider business mailing address

144 SOUTH L ST
DINUBA CA
93618-3000
US

V. Phone/Fax

Practice location:
  • Phone: 559-591-6680
  • Fax:
Mailing address:
  • Phone: 559-591-6680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 19537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: