Healthcare Provider Details

I. General information

NPI: 1902579311
Provider Name (Legal Business Name): MAGALI ESPINOZA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 SIERRA CT STE A-302
PALMDALE CA
93550-7607
US

IV. Provider business mailing address

190 SIERRA CT STE A-302
PALMDALE CA
93550-7607
US

V. Phone/Fax

Practice location:
  • Phone: 661-224-9310
  • Fax: 800-516-1658
Mailing address:
  • Phone: 661-224-9310
  • Fax: 800-516-1658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-169199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: