Provider Demographics
NPI:1205006012
Name:ESTELLA, JOEY A (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JOEY
Middle Name:A
Last Name:ESTELLA
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VENTURE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3340
Mailing Address - Country:US
Mailing Address - Phone:949-753-8800
Mailing Address - Fax:
Practice Address - Street 1:6 VENTURE
Practice Address - Street 2:SUITE 350
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3340
Practice Address - Country:US
Practice Address - Phone:949-753-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53188106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist