Provider Demographics
NPI:1275035768
Name:ESPIRITU, JENNY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:ESPIRITU
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 1:5348 UNIVERSITY AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-8025
Mailing Address - Country:US
Mailing Address - Phone:619-255-7550
Mailing Address - Fax:619-255-7538
Practice Address - Street 1:5348 UNIVERSITY AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-8025
Practice Address - Country:US
Practice Address - Phone:619-255-7550
Practice Address - Fax:619-255-7538
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor