Healthcare Provider Details

I. General information

NPI: 1780156356
Provider Name (Legal Business Name): ANGEL ESPARZA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11015 BLOOMFIELD AVE
SANTA FE SPRINGS CA
90670-4601
US

IV. Provider business mailing address

9620 BRYSON AVE
SOUTH GATE CA
90280-5050
US

V. Phone/Fax

Practice location:
  • Phone: 562-906-2676
  • Fax: 562-906-2687
Mailing address:
  • Phone: 323-517-0247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number108482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: