Provider Demographics
NPI:1164830915
Name:VAZQUEZ-ESPARZA, EMA GLORIA
Entity Type:Individual
Prefix:
First Name:EMA
Middle Name:GLORIA
Last Name:VAZQUEZ-ESPARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:VAZQUEZ-ESPARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10001 W FRONTAGE RD SPC 223
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-5401
Mailing Address - Country:US
Mailing Address - Phone:562-928-1599
Mailing Address - Fax:
Practice Address - Street 1:599 W 9TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3105
Practice Address - Country:US
Practice Address - Phone:310-831-0331
Practice Address - Fax:310-831-0004
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist