Healthcare Provider Details

I. General information

NPI: 1538072046
Provider Name (Legal Business Name): LAUREN ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 E OHIO AVE
ESCONDIDO CA
92025-3438
US

IV. Provider business mailing address

39753 NANTUCKET RD
TEMECULA CA
92591-7505
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax:
Mailing address:
  • Phone: 951-550-7458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number23007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: