Provider Demographics
NPI:1053924993
Name:ESPIRITU, SHELBY MICHELE ALANE (LMFT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:MICHELE ALANE
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28294
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92198-0294
Mailing Address - Country:US
Mailing Address - Phone:858-413-7746
Mailing Address - Fax:
Practice Address - Street 1:9655 GRANITE RIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2674
Practice Address - Country:US
Practice Address - Phone:858-413-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114109106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist