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General NPI Number Information
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NPI Number | 1932863487
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Entity Type | Individual
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Provider Name | ADAM LESPINASSE
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Gender | Male
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 1885 LUNDY AVE STE 223
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City | SAN JOSE
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State | CA
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Zip | 95131-1888
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Country | US
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Telephone | 909-763-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 10932 RAGSDALE RD
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City | LOMA LINDA
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State | CA
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Zip | 92354-6546
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Country | US
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Telephone | 909-222-0463
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 167G00000X
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Taxonomy Name | Licensed Psychiatric Technician
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License Number | 42124
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License Number State | CA
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