Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist | CA |
NPI | 1720632631 |
---|---|
Provider Name | Efren Esparza |
First Address | Santa Ana, CA 92701-5017 |
Second Address | Santa Ana, CA 92701-5017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2019 |
Last Update Date | 29/07/2019 |