Healthcare Provider Details

I. General information

NPI: 1720635683
Provider Name (Legal Business Name): MONICA LEONOR ESPINASSE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 STONERIDGE DR STE 100
BOZEMAN MT
59718-9850
US

IV. Provider business mailing address

1725 WEST KOCH STREET UNIT 10
BOZEMAN MT
59715
US

V. Phone/Fax

Practice location:
  • Phone: 415-359-7745
  • Fax:
Mailing address:
  • Phone: 415-359-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4582
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4582
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: