Doctor Name: | DR. CARRIE LEE ESPARZA |
NPI Number: | 1063593259 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PSY 18638 |
Business Practice Address: | 11705 Alameda St Century Regional Detention Facility Jail Mental Health Lynwood, CA - 902624023 |
Business Phone Number: | 3235684658 |
Business Fax Number: | |
Mailing Address: | Po Box 3384, LONG BEACH |
State: | CA |
Postal Code: | 908030384 |
Phone Number: | 5622184095 |
Fax Number: | 5622180372 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY 18638 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |