Provider Demographics
NPI:1811220395
Name:ESPINOZA, ERNIE N/A
Entity Type:Individual
Prefix:MR
First Name:ERNIE
Middle Name:N/A
Last Name:ESPINOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 CAMINO DEL REMEDIO
Mailing Address - Street 2:RM 258
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1332
Mailing Address - Country:US
Mailing Address - Phone:805-681-5450
Mailing Address - Fax:
Practice Address - Street 1:315 CAMINO DEL REMEDIO
Practice Address - Street 2:RM 258
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1332
Practice Address - Country:US
Practice Address - Phone:805-681-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3923Medicaid