Healthcare Provider Details

I. General information

NPI: 1558173617
Provider Name (Legal Business Name): VIRIDIANA ESPARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 WELLINGTON AVE
GRAND JUNCTION CO
81501-8122
US

IV. Provider business mailing address

1001 WELLINGTON AVE
GRAND JUNCTION CO
81501-8122
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-2437
  • Fax:
Mailing address:
  • Phone: 970-243-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: