Healthcare Provider Details

I. General information

NPI: 1336039015
Provider Name (Legal Business Name): LETICIA ESTRELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2025
Last Update Date: 07/05/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3835 AVOCADO BLVD STE 270
LA MESA CA
91941-8524
US

IV. Provider business mailing address

8865 ECHO DR
LA MESA CA
91941-6703
US

V. Phone/Fax

Practice location:
  • Phone: 619-268-1272
  • Fax:
Mailing address:
  • Phone: 619-328-7681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT118443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: