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General NPI Number Information
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NPI Number | 1285016683
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Entity Type | Individual
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Provider Name | MARDENE ANGELICA ESPARZA LCSW 99109
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 7901 ANDERS CIR
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City | LA MESA
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State | CA
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Zip | 91942-2304
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Country | US
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Telephone | 619-857-1218
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 ANDERS CIR
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City | LA MESA
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State | CA
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Zip | 91942-2304
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Country | US
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Telephone | 619-857-1218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 99109
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License Number State | CA
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