Provider Demographics
NPI:1992830301
Name:GONZALEZ, YAJAIRA ESTRELLA (BA)
Entity Type:Individual
Prefix:MRS
First Name:YAJAIRA
Middle Name:ESTRELLA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 WILKINS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-2020
Mailing Address - Country:US
Mailing Address - Phone:323-286-5567
Mailing Address - Fax:
Practice Address - Street 1:1162 WILKINS AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2020
Practice Address - Country:US
Practice Address - Phone:323-286-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor