Healthcare Provider Details

I. General information

NPI: 1932041530
Provider Name (Legal Business Name): RAUL ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 RESEDA BLVD
NORTHRIDGE CA
91324-4619
US

IV. Provider business mailing address

8330 RESEDA BLVD
NORTHRIDGE CA
91324-4619
US

V. Phone/Fax

Practice location:
  • Phone: 818-534-1829
  • Fax: 818-936-0108
Mailing address:
  • Phone: 818-534-1829
  • Fax: 818-936-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: