Provider Demographics
NPI:1033365911
Name:VILLASENOR, ESTELA
Entity Type:Individual
Prefix:MRS
First Name:ESTELA
Middle Name:
Last Name:VILLASENOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20610 ARCHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-4009
Mailing Address - Country:US
Mailing Address - Phone:323-992-5336
Mailing Address - Fax:
Practice Address - Street 1:21851 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2668
Practice Address - Country:US
Practice Address - Phone:818-346-1932
Practice Address - Fax:818-346-1676
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA4051237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist