Healthcare Provider Details

I. General information

NPI: 1164126439
Provider Name (Legal Business Name): MARIA ESTHER SIERRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N ALAMEDA ST STE 390
LOS ANGELES CA
90012-1804
US

IV. Provider business mailing address

13536 LAKEWOOD BLVD # 5630
BELLFLOWER CA
90706-2031
US

V. Phone/Fax

Practice location:
  • Phone: 213-804-3139
  • Fax:
Mailing address:
  • Phone: 323-603-5266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSB94026911
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPSB94026911
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: