Provider Demographics
NPI:1467584730
Name:ESTRADA, RUBY (MFT)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11745 FIRESTONE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-8851
Mailing Address - Country:US
Mailing Address - Phone:562-207-4272
Mailing Address - Fax:562-207-4279
Practice Address - Street 1:11745 FIRESTONE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-8851
Practice Address - Country:US
Practice Address - Phone:562-207-4272
Practice Address - Fax:562-207-4279
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health