Individual
ANDREW THEODORE EZPELETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACSW
Contact information
Practice address
27261 LAS RAMBLAS STE 220, MISSION VIEJO, CA 92691-6468
(714) 966-8650
Mailing address
PO BOX 676, LOMA LINDA, CA 92354-0676
(360) 213-5907
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
84637
CA
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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