Provider Demographics
NPI:1083288542
Name:ESPINOZA, DULCE
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:DULCE
Other - Middle Name:
Other - Last Name:ESPINOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 891
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95241-0891
Mailing Address - Country:US
Mailing Address - Phone:209-712-9416
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 891
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95241-0891
Practice Address - Country:US
Practice Address - Phone:209-712-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2025-05-07
Deactivation Date:2021-11-15
Deactivation Code:
Reactivation Date:2021-12-29
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA130540106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist