Healthcare Provider Details

I. General information

NPI: 1942977921
Provider Name (Legal Business Name): AMANDA ROSE CHIEN ESPARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 ZONAL AVE
LOS ANGELES CA
90089-5305
US

IV. Provider business mailing address

9862 OLIVE ST
TEMPLE CITY CA
91780-3236
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-1369
  • Fax:
Mailing address:
  • Phone: 626-824-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91696
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number48226
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: