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General NPI Number Information
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NPI Number | 1699053744
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Entity Type | Individual
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Provider Name | JAMES RIVAS ESPINOSA LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 299 12TH ST STE A
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City | MARINA
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State | CA
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Zip | 93933-6003
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Country | US
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Telephone | 831-647-7659
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1403
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City | SAN JUAN BAUTISTA
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State | CA
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Zip | 95045-1403
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Country | US
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Telephone | 209-205-0553
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 82444
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License Number State | CA
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