Provider Demographics
NPI:1922984012
Name:ESPINOZA ANGEL, HENRY (PPS)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:ESPINOZA ANGEL
Suffix:
Gender:M
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16429 VICTORY BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-5843
Mailing Address - Country:US
Mailing Address - Phone:818-817-1472
Mailing Address - Fax:
Practice Address - Street 1:90 N DAISY AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3704
Practice Address - Country:US
Practice Address - Phone:626-564-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220267046101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool