Healthcare Provider Details

I. General information

NPI: 1497604821
Provider Name (Legal Business Name): ALEXANDRIA ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3037 BRYANT PL
DAVIS CA
95618-1613
US

IV. Provider business mailing address

665 FERGUSON CT
DIXON CA
95620-4545
US

V. Phone/Fax

Practice location:
  • Phone: 209-416-2737
  • Fax:
Mailing address:
  • Phone: 209-416-2737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN733631
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: