Healthcare Provider Details

I. General information

NPI: 1902235393
Provider Name (Legal Business Name): IRENE GUADALUPE ESPINOZA INSUNZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: IRENE INSUNZA

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TYLER AVE
SOUTH EL MONTE CA
91733-3543
US

IV. Provider business mailing address

2000 TYLER AVE
SOUTH EL MONTE CA
91733-3543
US

V. Phone/Fax

Practice location:
  • Phone: 626-442-1400
  • Fax:
Mailing address:
  • Phone: 626-442-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: