Provider Demographics
NPI:1184910671
Name:ESPARZA, ERIKA ISABEL (MFT-I, RRW)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:ISABEL
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:MFT-I, RRW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 E 3RD ST UNIT 316
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-6711
Mailing Address - Country:US
Mailing Address - Phone:949-836-7249
Mailing Address - Fax:
Practice Address - Street 1:2607 WILLO LN
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4645
Practice Address - Country:US
Practice Address - Phone:949-313-1192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARW4190101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARW4190OtherRRW