Provider Demographics
NPI:1992336978
Name:ESPINOSA, DANIELLE MORALES
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MORALES
Last Name:ESPINOSA
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 1:255 S GLENDORA AVE UNIT 2281
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-7218
Mailing Address - Country:US
Mailing Address - Phone:626-657-0435
Mailing Address - Fax:
Practice Address - Street 1:4550 KEARNY VILLA RD STE 118
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1574
Practice Address - Country:US
Practice Address - Phone:626-657-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10033101YM0800X
CA127285106H00000X
CA144040106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health