Healthcare Provider Details

I. General information

NPI: 1639367394
Provider Name (Legal Business Name): MR. CHRISTOPHER ESPE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S ARROYO PKWY STE 100
PASADENA CA
91105-3973
US

IV. Provider business mailing address

385 S LOS ROBLES AVE APT 1
PASADENA CA
91101-3221
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-2794
  • Fax:
Mailing address:
  • Phone: 323-559-2876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number62757
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW80031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: