Basic Information
Provider Information
NPI: 1295344133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESPINOZA
FirstName: CESAR
MiddleName: ALBERTO
NamePrefix: MR.
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21000 PLUMMER ST
Address2:  
City: CHATSWORTH
State: CA
PostalCode: 913114903
CountryCode: US
TelephoneNumber: 8188826400
FaxNumber:  
Practice Location
Address1: 21000 PLUMMER ST
Address2:  
City: CHATSWORTH
State: CA
PostalCode: 913114903
CountryCode: US
TelephoneNumber: 8188826400
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/27/2020
LastUpdateDate: 04/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X98257CAN Behavioral Health & Social Service ProvidersSocial Worker 
101YM0800X98257CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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