Provider Demographics
NPI:1932346467
Name:ESTRADA, NATALIA ROCHA
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:ROCHA
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 1:1915 F AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5756
Mailing Address - Country:US
Mailing Address - Phone:619-336-1823
Mailing Address - Fax:
Practice Address - Street 1:1915 F AVE APT 19
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5756
Practice Address - Country:US
Practice Address - Phone:619-336-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker