Provider Demographics
NPI:1427329374
Name:ESPINOZA, MELISSA L (MSW, ASW, 34288)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:L
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MSW, ASW, 34288
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 E. ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2535
Mailing Address - Country:US
Mailing Address - Phone:909-398-4383
Mailing Address - Fax:909-445-8936
Practice Address - Street 1:831 E. ARROW HWY
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767
Practice Address - Country:US
Practice Address - Phone:909-398-4383
Practice Address - Fax:909-445-8936
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW #34288101YM0800X
CALCSW829221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health