Provider Demographics
NPI:1598273864
Name:ESPINOZA, LEONARDO (BS)
Entity Type:Individual
Prefix:
First Name:LEONARDO
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11129 ELLIOTT AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2419
Mailing Address - Country:US
Mailing Address - Phone:626-607-8308
Mailing Address - Fax:
Practice Address - Street 1:11129 ELLIOTT AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2419
Practice Address - Country:US
Practice Address - Phone:626-607-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator