Provider Demographics
NPI:1073369963
Name:ESPINOSA, IVETTE (HIS)
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 PARAMOUNT BLVD STE 236
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3853
Mailing Address - Country:US
Mailing Address - Phone:562-619-7378
Mailing Address - Fax:
Practice Address - Street 1:9901 PARAMOUNT BLVD STE 236
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3853
Practice Address - Country:US
Practice Address - Phone:562-619-7378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8937237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist