Basic Information
| Provider Information | |||||||||
| NPI: | 1417207051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESPINOZA | ||||||||
| FirstName: | HUGO | ||||||||
| MiddleName: | ALFREDO | ||||||||
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| Credential: | STUDENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3350 E 7TH ST # 439 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908045003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204090476 | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 COURT ST | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245041312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4344858865 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2012 | ||||||||
| LastUpdateDate: | 10/27/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 0024174031 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 390200000X | 803743 | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.