Provider Demographics
NPI:1366899627
Name:ESPINOSA, VICTORIA PATRICIA (MSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PATRICIA
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 OLD BAINBRIDGE RD
Mailing Address - Street 2:UNIT D
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-9215
Mailing Address - Country:US
Mailing Address - Phone:305-562-4020
Mailing Address - Fax:
Practice Address - Street 1:4500 W SHANNON LAKES DR STE 3
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309
Practice Address - Country:US
Practice Address - Phone:850-942-2000
Practice Address - Fax:850-942-2003
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW102461041C0700X
FLSW155531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical