Healthcare Provider Details

I. General information

NPI: 1518872753
Provider Name (Legal Business Name): GABRIELLE ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

IV. Provider business mailing address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

V. Phone/Fax

Practice location:
  • Phone: 661-215-5066
  • Fax:
Mailing address:
  • Phone: 661-215-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: