Active NPI
Frederick Espejo
- Licensed Psychiatric Technician
- Santa Ana, CA
National Provider Identifier
1316782519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Psychiatric Technician
- License
- 40804
- Practice address
- 1030 W Warner Ave
Santa Ana, CA 92707-3147 - Phone
- (714) 957-0611
- NPI assigned
- Jun 28, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Psychiatric Technician | 167G00000X | 40804 | CA | Primary |
Addresses
Primary practice location
1030 W Warner Ave
Santa Ana, CA 92707-3147
Mailing address
811 W Florence Ave
La Habra, CA 90631-4509
Phone (213) 210-9957
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 |
|---|---|---|---|
| 40804 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1316782519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 W FLORENCE AVE",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906314509",
"telephone_number": "213-210-9957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 W WARNER AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927073147",
"telephone_number": "714-957-0611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPEJO",
"first_name": "FREDERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-28",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "167G00000X",
"taxonomy_group": "",
"desc": "Licensed Psychiatric Technician",
"state": "CA",
"license": "40804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.