Provider Demographics
NPI:1619841053
Name:ESPESO, YSSA MARIE MAGNO
Entity type:Individual
Prefix:
First Name:YSSA MARIE
Middle Name:MAGNO
Last Name:ESPESO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17910 MALDEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3818
Mailing Address - Country:US
Mailing Address - Phone:747-266-8827
Mailing Address - Fax:
Practice Address - Street 1:3202 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2333
Practice Address - Country:US
Practice Address - Phone:310-829-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist