Healthcare Provider Details

I. General information

NPI: 1083288542
Provider Name (Legal Business Name): DULCE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DULCE ESPINOZA

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date: 11/15/2021
Reactivation Date: 12/29/2021

III. Provider practice location address

PO BOX 891
LODI CA
95241-0891
US

IV. Provider business mailing address

PO BOX 891
LODI CA
95241-0891
US

V. Phone/Fax

Practice location:
  • Phone: 209-712-9416
  • Fax:
Mailing address:
  • Phone: 209-712-9416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number130540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: