Provider Demographics
NPI:1902235393
Name:ESPINOZA INSUNZA, IRENE GUADALUPE
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:GUADALUPE
Last Name:ESPINOZA INSUNZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:INSUNZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2000 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-3543
Mailing Address - Country:US
Mailing Address - Phone:626-442-1400
Mailing Address - Fax:
Practice Address - Street 1:2000 TYLER AVE
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3543
Practice Address - Country:US
Practice Address - Phone:626-442-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist