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NPI Code Detail

MEDICARE: DR. LAURA ELENA ESPANA PSY.D.

MEDICARE: DR. LAURA ELENA ESPANA PSY.D.
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
1103T00000XPsychologist

General Provider Information

NPI Number : 1720277502
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA ELENA ESPANA PSY.D.
Provider Business Mailing Address
First Line : 14140 BEACH BLVD STE 155
Second Line :
City : WESTMINSTER
State : CA
Zip : 92683-4453
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4199 CAMPUS DR STE 550
Second Line :
City : IRVINE
State : CA
Zip : 92612-4694
Country : US
Telephone Number : 714-386-5766
Fax Number : 818-627-7888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 08/16/2012

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