Healthcare Provider Details

I. General information

NPI: 1043353485
Provider Name (Legal Business Name): COLETTE CONNORS ESPARZA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 W 226TH ST
TORRANCE CA
90505-2340
US

IV. Provider business mailing address

PO BOX 3771
REDONDO BEACH CA
90277-1708
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-4556
  • Fax: 310-373-4096
Mailing address:
  • Phone: 310-351-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC42538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: