MEDICARE: CLARISSA ESPINOZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian		OH

General Provider Information

NPI Number	:	1548079957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARISSA ESPINOZA

Provider Business Mailing Address
First Line	:	60 E SPRING ST APT 205
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-7522
Country	:	US
Telephone Number	:	214-892-6582
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 E SPRING ST APT 205
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-7522
Country	:	US
Telephone Number	:	214-892-6582
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2025
Last Update Date	:	02/12/2025

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Directions to “ CLARISSA ESPINOZA ” Practice Location

Language	Start Address	Practice Location

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