Healthcare Provider Details

I. General information

NPI: 1669093761
Provider Name (Legal Business Name): PAULA JOY ESPINOSA-SHAW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 840
HELENDALE CA
92342-0840
US

IV. Provider business mailing address

PO BOX 840
HELENDALE CA
92342-0840
US

V. Phone/Fax

Practice location:
  • Phone: 760-912-0678
  • Fax:
Mailing address:
  • Phone: 760-912-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: