Healthcare Provider Details

I. General information

NPI: 1366028870
Provider Name (Legal Business Name): OMAR ESPINOZA M.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 W JAMES CT
VISALIA CA
93277-7564
US

IV. Provider business mailing address

815 W JAMES CT
VISALIA CA
93277-7564
US

V. Phone/Fax

Practice location:
  • Phone: 559-568-5526
  • Fax:
Mailing address:
  • Phone: 559-568-5526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC9680
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC9680
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: