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General NPI Number Information
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NPI Number | 1780939074
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Entity Type | Individual
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Provider Name | ESPERANZA CEJA
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Gender | Female
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 1900 SYCAMORE CANYON RD
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City | SAN DIMAS
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State | CA
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Zip | 91773-1220
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Country | US
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Telephone | 909-592-0579
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 E WASHINGTON BLVD STE 230
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City | PASADENA
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State | CA
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Zip | 91107-1449
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Country | US
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Telephone | 626-296-8900
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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 | LCSW80924
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License Number State | CA
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