Provider Demographics
NPI:1437830924
Name:ESTRADA, LIDIA N
Entity Type:Individual
Prefix:
First Name:LIDIA
Middle Name:N
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 W CATALPA DR APT 15
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4111
Mailing Address - Country:US
Mailing Address - Phone:562-632-0805
Mailing Address - Fax:
Practice Address - Street 1:1664 W CATALPA DR APT 15
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4111
Practice Address - Country:US
Practice Address - Phone:562-632-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker