Provider Demographics
NPI:1538545702
Name:ESPINOSA, ARIAM MARLENE
Entity type:Individual
Prefix:
First Name:ARIAM
Middle Name:MARLENE
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:PO BOX 3405
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93927-3405
Mailing Address - Country:US
Mailing Address - Phone:831-905-7042
Mailing Address - Fax:831-772-8154
Practice Address - Street 1:355 BROADWAY SUITE. D
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:CA
Practice Address - Zip Code:93930
Practice Address - Country:US
Practice Address - Phone:831-905-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI 88450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist