Provider Demographics
NPI:1407613367
Name:ESPINOZA, ANGELY
Entity Type:Individual
Prefix:
First Name:ANGELY
Middle Name:
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 1:2301 ANDRADE AVE APT 238
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-3995
Mailing Address - Country:US
Mailing Address - Phone:760-672-7467
Mailing Address - Fax:
Practice Address - Street 1:2301 ANDRADE AVE APT 238
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-3995
Practice Address - Country:US
Practice Address - Phone:760-672-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst