Doctor Name: | SANDRA LUZ ESPINOVA-BRADFORD |
NPI Number: | 1255644928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 102 W Main St San Jacinto, CA - 925834121 |
Business Phone Number: | 9516634827 |
Business Fax Number: | |
Mailing Address: | Po Box 3868, HEMET |
State: | CA |
Postal Code: | 925463868 |
Phone Number: | 9516634827 |
Fax Number: | |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |