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NPI Code Detail

MEDICARE: MR. FERNANDO ESPINOSA

MEDICARE: MR. FERNANDO ESPINOSA
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1821306432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FERNANDO ESPINOSA
Provider Business Mailing Address
First Line : 4964 NOVATO CIR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1730
Country : US
Telephone Number : 801-674-6034
Fax Number :
Provider Business Practice Location Address
First Line : 3170 E SUNSET RD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-2755
Country : US
Telephone Number : 702-629-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2010
Last Update Date : 09/16/2010

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Directions to “ MR. FERNANDO ESPINOSA ” Practice Location

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