Healthcare Provider Details

I. General information

NPI: 1881061604
Provider Name (Legal Business Name): SAMUEL ESTEBAN NAVARRO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WOOD ST
EUREKA CA
95501-4413
US

IV. Provider business mailing address

2036 NELSON RD
MCKINLEYVILLE CA
95519-4241
US

V. Phone/Fax

Practice location:
  • Phone: 707-268-2990
  • Fax:
Mailing address:
  • Phone: 707-616-9726
  • Fax: 707-633-6292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN689994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: