Healthcare Provider Details

I. General information

NPI: 1023501319
Provider Name (Legal Business Name): BEATRICE ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5190 ATLANTIC AVE
LONG BEACH CA
90805-6510
US

IV. Provider business mailing address

5190 ATLANTIC AVE
LONG BEACH CA
90805-6510
US

V. Phone/Fax

Practice location:
  • Phone: 562-428-4111
  • Fax: 562-984-5610
Mailing address:
  • Phone: 562-428-4111
  • Fax: 562-984-5610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: