Provider Demographics
NPI:1861825853
Name:ESPARZA, ANTHONY EDWARD SR (CDP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:EDWARD
Last Name:ESPARZA
Suffix:SR
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 YOUNG ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1155
Mailing Address - Country:US
Mailing Address - Phone:509-930-1442
Mailing Address - Fax:
Practice Address - Street 1:33 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3414
Practice Address - Country:US
Practice Address - Phone:509-567-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60010893101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)