Healthcare Provider Details

I. General information

NPI: 1497164123
Provider Name (Legal Business Name): DAVID ESHLEMAN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 TORRANCE BLVD
REDONDO BEACH CA
90277-3325
US

IV. Provider business mailing address

404 TORRANCE BLVD
REDONDO BEACH CA
90277-3325
US

V. Phone/Fax

Practice location:
  • Phone: 310-906-0030
  • Fax:
Mailing address:
  • Phone: 310-906-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number78065
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT109797
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: