Provider Demographics
NPI:1689160798
Name:ESTRADA, ALEXANDRA MAGDALENA
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MAGDALENA
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 1:11843 BRAESVIEW APT 2207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-5808
Mailing Address - Country:US
Mailing Address - Phone:956-489-4926
Mailing Address - Fax:
Practice Address - Street 1:11843 BRAESVIEW APT 2207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-5808
Practice Address - Country:US
Practice Address - Phone:956-489-4926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst