Provider Demographics
NPI:1760898878
Name:ESTRADA, ROSA ELISA
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:ELISA
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ROSA
Other - Middle Name:ELISA
Other - Last Name:ESTRADA ARGUETA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0257
Practice Address - Street 1:810 CAPP ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3225
Practice Address - Country:US
Practice Address - Phone:415-285-0180
Practice Address - Fax:415-285-2110
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker