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General NPI Number Information
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NPI Number | 1801443379
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Entity Type | Individual
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Provider Name | NANCY WALLIN ESPINOZA
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 17215 STARK AVE
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City | CERRITOS
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State | CA
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Zip | 90703-1821
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Country | US
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Telephone | 562-353-7261
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Fax |
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Provider Business Mailing Address
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Address Line | 11432 SOUTH ST #383
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City | CERRITOS
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State | CA
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Zip | 90703-6611
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Country | US
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Telephone | 562-400-2211
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT126224
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License Number State | CA
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