Provider Demographics
NPI:1831966746
Name:ESPIRITU, LANCE (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:LANCE
Middle Name:
Last Name:ESPIRITU
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13723 DON JULIAN RD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746-2715
Mailing Address - Country:US
Mailing Address - Phone:626-320-3257
Mailing Address - Fax:
Practice Address - Street 1:13723 DON JULIAN RD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-2715
Practice Address - Country:US
Practice Address - Phone:626-320-3257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027065363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health