Provider Demographics
NPI:1376903336
Name:ESTRELLA, HUMBERTO JHAIR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HUMBERTO
Middle Name:JHAIR
Last Name:ESTRELLA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 WILLOW PASS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5225
Mailing Address - Country:US
Mailing Address - Phone:925-676-7431
Mailing Address - Fax:
Practice Address - Street 1:1333 WILLOW PASS RD STE 100
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5225
Practice Address - Country:US
Practice Address - Phone:925-676-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291189225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist