Provider Demographics
NPI:1437213972
Name:JEBRIL, ESTELA RODRIGUEZ (ASW)
Entity Type:Individual
Prefix:
First Name:ESTELA
Middle Name:RODRIGUEZ
Last Name:JEBRIL
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9634 INDIAN CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-6823
Mailing Address - Country:US
Mailing Address - Phone:760-715-5733
Mailing Address - Fax:760-297-1398
Practice Address - Street 1:1029 N BROADWAY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3043
Practice Address - Country:US
Practice Address - Phone:760-291-8729
Practice Address - Fax:760-489-4129
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6467OtherMEDICAL PROVIDER NUMBER