Provider Demographics
NPI:1164838520
Name:ESPINOZA, LINDA TATIANA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:TATIANA
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6187 ATLANTIC AVE # 2053
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2922
Mailing Address - Country:US
Mailing Address - Phone:562-245-9828
Mailing Address - Fax:866-280-7964
Practice Address - Street 1:6187 ATLANTIC AVE # 2053
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2922
Practice Address - Country:US
Practice Address - Phone:562-245-9828
Practice Address - Fax:866-280-7964
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67202101YM0800X
TX1067921041C0700X
CALCSW882241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty