Provider Demographics
NPI:1124549597
Name:ESPINOZA, EMILY K (CADC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:TURGESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1003 E MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7140
Mailing Address - Country:US
Mailing Address - Phone:541-326-4905
Mailing Address - Fax:
Practice Address - Street 1:1003 E MAIN ST STE 130
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7140
Practice Address - Country:US
Practice Address - Phone:541-326-4905
Practice Address - Fax:541-326-4905
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17-06-17101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134150Medicaid