Healthcare Provider Details

I. General information

NPI: 1821048083
Provider Name (Legal Business Name): JENNIFER L ESTRELLA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11480 BROOKSHIRE AVE SUITE 111
DOWNEY CA
90241-5010
US

IV. Provider business mailing address

11480 BROOKSHIRE AVE SUITE 111
DOWNEY CA
90241-5010
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-1651
  • Fax: 562-904-1656
Mailing address:
  • Phone: 562-904-1651
  • Fax: 562-904-1656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN305947
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: