Healthcare Provider Details

I. General information

NPI: 1831879246
Provider Name (Legal Business Name): ANGEL GARCIA ESPINOZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 VIEWRIDGE AVE STE 100A
SAN DIEGO CA
92123-1638
US

IV. Provider business mailing address

7080 SARANAC ST APT 53
LA MESA CA
91942-8963
US

V. Phone/Fax

Practice location:
  • Phone: 760-227-1354
  • Fax:
Mailing address:
  • Phone: 562-588-1276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: