Healthcare Provider Details

I. General information

NPI: 1003447053
Provider Name (Legal Business Name): ESPERANZA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 HERITAGE LN STE 260
SACRAMENTO CA
95815-4945
US

IV. Provider business mailing address

1851 HERITAGE LN STE 260
SACRAMENTO CA
95815-4945
US

V. Phone/Fax

Practice location:
  • Phone: 916-692-8519
  • Fax: 916-200-4992
Mailing address:
  • Phone: 530-228-4904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: LUIS GUTIERREZ
Title or Position: CEO
Credential: BCBA
Phone: 530-228-4904