Provider Demographics
NPI:1427861673
Name:ESPARZA, MICHELLE BRITNEY (EDS, LEP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BRITNEY
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:EDS, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 AGUSTIN NARVAEZ ST UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-5032
Mailing Address - Country:US
Mailing Address - Phone:559-708-5509
Mailing Address - Fax:
Practice Address - Street 1:2010 EL CAMINO REAL # 1310
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4051
Practice Address - Country:US
Practice Address - Phone:559-708-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4433103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist