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General NPI Number Information
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NPI Number | 1700101276
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Entity Type | Individual
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Provider Name | MARY ESPINOZA M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 14724 VENTURA BLVD STE 1100
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3501
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Country | US
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Telephone | 310-551-7705
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Fax | 661-295-8752
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Provider Business Mailing Address
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Address Line | 29755 CASTLEBURY PL
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City | CASTAIC
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State | CA
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Zip | 91384-3823
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Country | US
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Telephone | 818-370-3108
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Fax | 661-295-8752
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 25459
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License Number State | CA
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