Provider Demographics
NPI:1568850253
Name:ESTELL, CHERRELYN (NP)
Entity Type:Individual
Prefix:
First Name:CHERRELYN
Middle Name:
Last Name:ESTELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERRELYN
Other - Middle Name:
Other - Last Name:ESTELL - HIGGINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 92944
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109
Mailing Address - Country:US
Mailing Address - Phone:626-399-6777
Mailing Address - Fax:800-456-7698
Practice Address - Street 1:7451 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-2803
Practice Address - Country:US
Practice Address - Phone:818-765-5400
Practice Address - Fax:818-765-5402
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005778363LF0000X, 363LP0808X, 363LP2300X
CA66328101YM0800X, 106H00000X
CA95048955163WC0400X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist