Provider Demographics
NPI:1376091520
Name:ESTRADA, ALLYANA ASHLEY (LVN)
Entity Type:Individual
Prefix:
First Name:ALLYANA
Middle Name:ASHLEY
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 BOYS REPUBLIC DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-5447
Mailing Address - Country:US
Mailing Address - Phone:909-628-1217
Mailing Address - Fax:909-627-9222
Practice Address - Street 1:1907 BOYS REPUBLIC DR
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-5447
Practice Address - Country:US
Practice Address - Phone:909-628-1217
Practice Address - Fax:909-993-1106
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273837164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse