Basic Information
Provider Information
NPI: 1821126855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESPINOSA
FirstName: PABLO
MiddleName: HURTADO
NamePrefix: MR.
NameSuffix: III
Credential: MFTI
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 711 N COURT ST
Address2:  
City: VISALIA
State: CA
PostalCode: 932913638
CountryCode: US
TelephoneNumber: 5596271490
FaxNumber: 5597327942
Practice Location
Address1: 711 N COURT ST
Address2:  
City: VISALIA
State: CA
PostalCode: 932913638
CountryCode: US
TelephoneNumber: 5596271490
FaxNumber: 5597327942
Other Information
ProviderEnumerationDate: 03/01/2007
LastUpdateDate: 03/28/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X74687CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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