Provider Demographics
NPI:1346783370
Name:RICHARD ESPINOZA, PSY.D, PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:RICHARD ESPINOZA, PSY.D, PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-508-7907
Mailing Address - Street 1:PO BOX 78422
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-0422
Mailing Address - Country:US
Mailing Address - Phone:323-508-7907
Mailing Address - Fax:
Practice Address - Street 1:3401 GLENDALE BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1814
Practice Address - Country:US
Practice Address - Phone:323-508-7907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28726103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty