Healthcare Provider Details

I. General information

NPI: 1235840810
Provider Name (Legal Business Name): PAOLA MICHELLE ESTRELLA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9310 SIERRA AVE
FONTANA CA
92335-5711
US

IV. Provider business mailing address

13885 MESQUITE DR
FONTANA CA
92337-0794
US

V. Phone/Fax

Practice location:
  • Phone: 866-205-3595
  • Fax:
Mailing address:
  • Phone: 909-697-7812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number132374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: