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General NPI Number Information
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NPI Number | 1649904996
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Entity Type | Individual
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Provider Name | ALEJANDRO CORONA ESPINOSA PH.D., HSPP
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Gender | Male
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 09/21/2025
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Provider Practice Location Address
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Address Line | 3220 E JEFFERSON BLVD
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City | SOUTH BEND
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State | IN
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Zip | 46615-3028
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Country | US
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Telephone | 574-222-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 52266 TAMMY DR
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City | GRANGER
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State | IN
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Zip | 46530-9588
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Country | US
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Telephone | 716-908-9559
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20043909B
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043909B
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License Number State | IN
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