Healthcare Provider Details

I. General information

NPI: 1770008187
Provider Name (Legal Business Name): RYAN DARRYL ESPINOZA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S WADSWORTH BLVD
LAKEWOOD CO
80227-3414
US

IV. Provider business mailing address

10190 W BERRY DR
LITTLETON CO
80127-1856
US

V. Phone/Fax

Practice location:
  • Phone: 720-989-1905
  • Fax:
Mailing address:
  • Phone: 303-956-9805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0011972
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: