Provider Demographics
NPI:1427533819
Name:COLOCHO, AIDA ESTELA (LCSW 86181)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:ESTELA
Last Name:COLOCHO
Suffix:
Gender:F
Credentials:LCSW 86181
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 FOOTHILL BLVD # 8115
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2516
Mailing Address - Country:US
Mailing Address - Phone:818-441-8892
Mailing Address - Fax:
Practice Address - Street 1:3239 ALTURA AVE APT 20
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-3393
Practice Address - Country:US
Practice Address - Phone:818-441-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical