Healthcare Provider Details

I. General information

NPI: 1891198586
Provider Name (Legal Business Name): VALERIA ESPARZA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 LAUREL CANYON BLVD SUITE 560
NORTH HOLLYWOOD CA
91606-1571
US

IV. Provider business mailing address

831 N FORMOSA AVE
LOS ANGELES CA
90046-7611
US

V. Phone/Fax

Practice location:
  • Phone: 818-763-0136
  • Fax: 818-763-3838
Mailing address:
  • Phone: 562-607-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOT 14545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: