Healthcare Provider Details

I. General information

NPI: 1497130892
Provider Name (Legal Business Name): YESENIA ESPINOZA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12130 PARAMOUNT BLVD
DOWNEY CA
90242
US

IV. Provider business mailing address

12130 PARAMOUNT BLVD
DOWNEY CA
90242-2339
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-9414
  • Fax:
Mailing address:
  • Phone: 562-923-9414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number90054
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: