Healthcare Provider Details

I. General information

NPI: 1629468855
Provider Name (Legal Business Name): VERONICA MARIA ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 W 6TH ST STE 411
LOS ANGELES CA
90020-5112
US

IV. Provider business mailing address

3727 W 6TH ST STE 411
LOS ANGELES CA
90020-5112
US

V. Phone/Fax

Practice location:
  • Phone: 213-365-7400
  • Fax: 213-201-3993
Mailing address:
  • Phone: 213-365-7400
  • Fax: 213-201-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number73737
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: