Active NPI
Patricia G Espinoza, LLP
- Psychologist
- Jenison, MI
National Provider Identifier
1104060649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 63010112207
- Practice address
- 1836 Baldwin St
Jenison, MI 49428-8901 - Phone
- (616) 457-0016
- Fax
- (616) 457-1950
- NPI assigned
- Apr 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 63010112207 | MI | Primary |
Addresses
Primary practice location
1836 Baldwin St
Jenison, MI 49428-8901
Mailing address
1726 North Bay Drive
Hudsonville, MI 49426
Phone (616) 262-7572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63010112207 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1104060649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1726 NORTH BAY DRIVE",
"city": "HUDSONVILLE",
"state": "MI",
"postal_code": "49426",
"telephone_number": "616-262-7572",
"fax_number": "616-457-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1836 BALDWIN ST",
"city": "JENISON",
"state": "MI",
"postal_code": "494288901",
"telephone_number": "616-457-0016",
"fax_number": "616-457-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPINOZA",
"first_name": "PATRICIA",
"middle_name": "G",
"name_prefix": "Mrs.",
"credential": "LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-28",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "63010112207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.