Healthcare Provider Details

I. General information

NPI: 1023679156
Provider Name (Legal Business Name): DELFINO ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WILSHIRE BLVD STE 300
LOS ANGELES CA
90017-1931
US

IV. Provider business mailing address

1200 WILSHIRE BLVD STE 300
LOS ANGELES CA
90017-1931
US

V. Phone/Fax

Practice location:
  • Phone: 213-819-2234
  • Fax:
Mailing address:
  • Phone: 213-819-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12661
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT136328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: