Healthcare Provider Details

I. General information

NPI: 1689294068
Provider Name (Legal Business Name): MARIYA ESPARZA SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2020
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26960 STORRIE LAKE DR
MORENO VALLEY CA
92555-4958
US

IV. Provider business mailing address

26960 STORRIE LAKE DR
MORENO VALLEY CA
92555-4958
US

V. Phone/Fax

Practice location:
  • Phone: 951-893-0350
  • Fax:
Mailing address:
  • Phone: 951-893-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: