Provider Demographics
NPI:1740087204
Name:ESPINOSA, RYLAN TAYLOR
Entity type:Individual
Prefix:
First Name:RYLAN
Middle Name:TAYLOR
Last Name:ESPINOSA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3368 PARKS AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7463
Mailing Address - Country:US
Mailing Address - Phone:559-731-8584
Mailing Address - Fax:
Practice Address - Street 1:1500 S MOONEY BLVD
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4403
Practice Address - Country:US
Practice Address - Phone:559-731-8584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician