Provider Demographics
NPI:1932962198
Name:ESTRADA, MARIA NATHALY
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:NATHALY
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 1:609 SANTA MARIA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-0608
Mailing Address - Country:US
Mailing Address - Phone:949-312-8337
Mailing Address - Fax:
Practice Address - Street 1:609 SANTA MARIA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-0608
Practice Address - Country:US
Practice Address - Phone:949-312-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst