Healthcare Provider Details

I. General information

NPI: 1639761265
Provider Name (Legal Business Name): KRISTY GABRIELA ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13135 BARTON RD
WHITTIER CA
90605-2757
US

IV. Provider business mailing address

9351 WASHBURN RD APT 5
DOWNEY CA
90242-2954
US

V. Phone/Fax

Practice location:
  • Phone: 562-944-2794
  • Fax:
Mailing address:
  • Phone: 562-387-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: